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Case 8

Patient Presentation: A 20-year-old male presented to clinic with markedly decreased vision in the right eye for the past 7 days. On examination, vision was 20/400 OD and 20/20 OS. There was a trace right RAPD. Fundus examination demonstrated the following:

Given the decline in vision, an OCT macula OD was performed below:

Retina 8-1.png
Retina 8-2.png

Describe the OCT

Question: What is the most likely diagnosis?

Question: What is the most common infectious etiology that causes this condition in adults?

Retina 8-2.png

Learning Objectives:

1. Identify OCT features of neuroretinitis. OCT will demonstrate significant optic disc edema with contiguous spread to the macula, indicated by retinal thickening and intra-retinal and subretinal fluid. OCT rNFL and SD-OCT of the optic nerve will likewise demonstrate an increased thickness of the retinal nerve fiber layer and peripapillary retina. 

2. Recognize Bartonella Henselae as the most common infectious etiology in neuro-retinitis.

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