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Neuroretinitis

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Intraocular Inflammation

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Abstract

Neuroretinitis was first described in 1916 by the German ophthalmologist Theodor Karl Gustav von Leber [1], who described a condition of unilateral vision loss associated with optic disc edema and a stellate pattern of macular exudates. Believing this represented retinal dysfunction, Leber characterized the condition as an “idiopathic stellate maculopathy.” Since then, the condition has gone by several names, including Leber’s stellate maculopathy, acute macular neuroretinopathy, Leber’s idiopathic stellate neuroretinitis, and Leber’s stellate optic neuritis. Gass and others recognized that disc swelling preceded the formation of the macular exudates and that the retinal vessels were angiographically quiescent. These observations lead Gass and others to suggest that the exudates arise from the optic disc and not the retina. Gass hypothesized further that the process resulted from an inflammatory insult to the optic nerve and renamed the syndrome “neuroretinitis”. Neuroretinitis is relatively rare, described in less than 1 % of all patients in large uveitis surveys. A number of infectious and noninfectious causes of neuroretinitis have been identified (Tables 47.1a and 47.1b).

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References

  1. Beck RW, Sergott RC, Barr CC et al (1984) Optic disc edema in the presumed ocular histoplasmosis syndrome. Ophthalmology 91:183–185

    Article  CAS  PubMed  Google Scholar 

  2. Carithers HA (1985) Cat-scratch disease. An overview based on a study of 1,200 patients. Am J Dis Child 139:1124–1133

    Article  CAS  PubMed  Google Scholar 

  3. Carroll DM, Franklin RM (1982) Leber’s idiopathic stellate retinopathy. Am J Ophthalmol 93:96–101

    Article  CAS  PubMed  Google Scholar 

  4. Cohen SM, Davis JL, Gass DM (1995) Branch retinal arterial occlusions in multifocal retinitis with optic nerve edema. Arch Ophthalmol 113:1271–1276

    Article  CAS  PubMed  Google Scholar 

  5. Dalton MJ, Robinson LE, Cooper J et al (1995) Use of Bartonella antigens for serologic diagnosis of cat-scratch disease at a national referral center. Arch Intern Med 155:1670–1676

    Article  CAS  PubMed  Google Scholar 

  6. Dreyer RF, Hopen G, Gass JD et al (1984) Leber’s idiopathic stellate neuroretinitis. Arch Ophthalmol 102:1140–1145

    Article  CAS  PubMed  Google Scholar 

  7. Fine M, Flocks M (1953) Bilateral acute neuroretinitis with sarcoidosis treated with corticotropin and cortisone. AMA Arch Ophthalmol 50:358–362

    Article  CAS  PubMed  Google Scholar 

  8. Fish RH, Hoskins JC, Kline LB (1993) Toxoplasmosis neuroretinitis. Ophthalmology 100:1177–1182

    Article  CAS  PubMed  Google Scholar 

  9. Foster RE, Lowder CY, Meisler DM et al (1990) Mumps neuroretinitis in an adolescent. Am J Ophthalmol 110:91–93

    Article  CAS  PubMed  Google Scholar 

  10. Fusco R, Magli A, Guacci P (1986) Stellate maculopathy due to Salmonella typhi. A case report. Ophthalmologica 192:154–158

    Article  CAS  PubMed  Google Scholar 

  11. Garcia-Arumi J, Salvador F, Corcostegui B et al (1994) Neuroretinitis associated with melanocytoma of the optic disk. Retina 14:173–176

    Article  CAS  PubMed  Google Scholar 

  12. Gass JD (1977) Diseases of the optic nerve that may simulate macular disease. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 83:763–770

    CAS  PubMed  Google Scholar 

  13. Gass JD, Gilbert WR Jr, Guerry RK et al (1978) Diffuse unilateral subacute neuroretinitis. Ophthalmology 85:521–545

    Article  CAS  PubMed  Google Scholar 

  14. Gass JDM (1997) Stereoscopic atlas of macular diseases: diagnosis and treatment. Mosby-Year Book, St. Louis, pp 996–999

    Google Scholar 

  15. Golnik KC, Marotto ME, Fanous MM et al (1994) Ophthalmic manifestations of Rochalimaea species. Am J Ophthalmol 118:145–151

    Article  CAS  PubMed  Google Scholar 

  16. Halperin LS (1992) Neuroretinitis due to seronegative syphilis associated with human immunodeficiency virus. J Clin Neuroophthalmol 12:171–172

    CAS  PubMed  Google Scholar 

  17. Hudson HL, Thach AB, Lopez PF (1997) Retinal manifestations of acute murine typhus. Int Ophthalmol 21:121–126

    Article  CAS  PubMed  Google Scholar 

  18. Johnson BL, Wisotzkey HM (1977) Neuroretinitis associated with herpes simplex encephalitis in an adult. Am J Ophthalmol 83:481–489

    Article  CAS  PubMed  Google Scholar 

  19. Karma A, Seppala I, Mikkila H et al (1995) Diagnosis and clinical characteristics of ocular Lyme borreliosis. Am J Ophthalmol 119:127–135

    Article  CAS  PubMed  Google Scholar 

  20. Leavitt JA, Pruthi S, Morgenstern BZ (1997) Hypertensive retinopathy mimicking neuroretinitis in a twelve-year-old girl. Surv Ophthalmol 41:477–480

    Article  CAS  PubMed  Google Scholar 

  21. Leber T (1916) Die pseudonephritischen Netzhauterkrankungen, die Retinitis stellata: die Purtschersche Netzhautaffektion nach schwerer Schaedelverletzung. In: Graefe AC, Saemisch T (eds) Handbuch der gesamten Augenheilkunde, 2nd edn. Engelmann, Leipzig, p 1319

    Google Scholar 

  22. Lee AG, Beaver HA (2002) Acute bilateral optic disk edema with a macular star figure in a 12-year-old girl. Surv Ophthalmol 47:42–49

    Article  PubMed  Google Scholar 

  23. Lesser RL, Kornmehl EW, Pachner AR et al (1990) Neuro-ophthalmologic manifestations of Lyme disease. Ophthalmology 97:699–706

    Article  CAS  PubMed  Google Scholar 

  24. Maitland CG, Miller NR (1984) Neuroretinitis. Arch Ophthalmol 102:1146–1150

    Article  CAS  PubMed  Google Scholar 

  25. Margileth AM (1992) Antibiotic therapy for cat-scratch disease: clinical study of therapeutic outcome in 268 patients and a review of the literature. Pediatr Infect Dis J 11:474–478

    Article  CAS  PubMed  Google Scholar 

  26. Matsuda A, Chin S, Ohashi T (1994) A case of neuroretinitis associated with long-standing polyarteritis nodosa. Ophthalmologica 208:168–171

    Article  CAS  PubMed  Google Scholar 

  27. McLeish WM, Pulido JS, Holland S et al (1990) The ocular manifestations of syphilis in the human immunodeficiency virus type 1-infected host. Ophthalmology 97:196–203

    Article  CAS  PubMed  Google Scholar 

  28. Noble KG (1997) Hypertensive retinopathy simulating Leber idiopathic stellate neuroretinitis. Arch Ophthalmol 115:1594–1595

    Article  CAS  PubMed  Google Scholar 

  29. Ormerod LD, Dailey JP (1999) Ocular manifestations of cat-scratch disease. Curr Opin Ophthalmol 10:209–216

    Article  CAS  PubMed  Google Scholar 

  30. Ormerod LD, Skolnick KA, Menosky MM et al (1998) Retinal and choroidal manifestations of cat-scratch disease. Ophthalmology 105:1024–1031

    Article  CAS  PubMed  Google Scholar 

  31. Purvin VA, Chioran G (1994) Recurrent neuroretinitis. Arch Ophthalmol 112:365–371

    Article  CAS  PubMed  Google Scholar 

  32. Ray S, Gragoudas E (2001) Neuroretinitis. Int Ophthalmol Clin 41:83–102

    Article  CAS  PubMed  Google Scholar 

  33. Roe RH, Michael Jumper J, Fu AD et al (2008) Ocular bartonella infections. Int Ophthalmol Clin 48:93–105

    Article  PubMed  Google Scholar 

  34. Shoari M, Katz BJ (2005) Recurrent neuroretinitis in an adolescent with ulcerative colitis. J Neuroophthalmol 25:286–288

    Article  PubMed  Google Scholar 

  35. Singh R, Gupta V, Gupta A (2004) Pattern of uveitis in a referral eye clinic in north India. Indian J Ophthalmol 52:121–125

    PubMed  Google Scholar 

  36. Solley WA, Martin DF, Newman NJ et al (1999) Cat scratch disease: posterior segment manifestations. Ophthalmology 106:1546–1553

    Article  CAS  PubMed  Google Scholar 

  37. Spalton DJ, Murdoch I, Holder GE (1989) Coxsackie B5 papillitis. J Neurol Neurosurg Psychiatry 52:1310–1311

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Stechschulte SU, Kim RY, Cunningham ET Jr (1999) Tuberculous neuroretinitis. J Neuroophthalmol 19:201–204

    Article  CAS  PubMed  Google Scholar 

  39. Suhler EB, Lauer AK, Rosenbaum JT (2000) Prevalence of serologic evidence of cat scratch disease in patients with neuroretinitis. Ophthalmology 107:871–876

    Article  CAS  PubMed  Google Scholar 

  40. Sweeney VP, Drance SM (1970) Optic neuritis and compressive neuropathy associated with cat scratch disease. Can Med Assoc J 103:1380–1381

    PubMed Central  CAS  PubMed  Google Scholar 

  41. Verm A, Lee AG (1997) Bilateral optic disk edema with macular exudates as the manifesting sign of a cerebral arteriovenous malformation. Am J Ophthalmol 123:422–424

    Article  CAS  PubMed  Google Scholar 

  42. Wade NK, Levi L, Jones MR et al (2000) Optic disk edema associated with peripapillary serous retinal detachment: an early sign of systemic Bartonella henselae infection. Am J Ophthalmol 130:327–334

    Article  CAS  PubMed  Google Scholar 

  43. Wade NK, Po S, Wong IG et al (1999) Bilateral Bartonella-associated neuroretinitis. Retina 19:355–356

    Article  CAS  PubMed  Google Scholar 

  44. Wakabayashi T, Morimura Y, Miyamoto Y et al (2003) Changing patterns of intraocular inflammatory disease in Japan. Ocul Immunol Inflamm 11:277–286

    Article  PubMed  Google Scholar 

  45. Warwick WJ (1967) The cat-scratch syndrome, many diseases or one disease? Prog Med Virol 9:256–301

    CAS  PubMed  Google Scholar 

  46. Wong MT, Dolan MJ, Lattuada CP Jr et al (1995) Neuroretinitis, aseptic meningitis, and lymphadenitis associated with Bartonella (Rochalimaea) henselae infection in immunocompetent patients and patients infected with human immunodeficiency virus type 1. Clin Infect Dis 21:352–360

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Retina Consultants San Diego, 9850 Genesee Ave. Ste. 700, La Jolla, CA, 92130, USA

    Nikolas J. S. London MD

  2. The Uveitis Service, California Pacific Medical Center, San Francisco, CA, USA

    Emmett T. Cunningham Jr. MD, PhD, MPH

  3. Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA

    Emmett T. Cunningham Jr. MD, PhD, MPH

  4. The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA

    Emmett T. Cunningham Jr. MD, PhD, MPH

  5. West Coast Retina Medical Group, Inc., San Francisco, CA, USA

    Emmett T. Cunningham Jr. MD, PhD, MPH

Authors
  1. Nikolas J. S. London MD
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  2. Emmett T. Cunningham Jr. MD, PhD, MPH
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Corresponding author

Correspondence to Emmett T. Cunningham Jr. MD, PhD, MPH .

Editor information

Editors and Affiliations

  1. Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany

    Manfred Zierhut

  2. Biomedical Research Centre, Institute of Ophthalmology, Moorfields Eyes Hospital, Department of Medical Retina, UCL, London, United Kingdom

    Carlos Pavesio

  3. School of Medicine, Department of Ophthalmology, Hokkaido University Graduate, Sapporo, Hokkaido, Japan

    Shigeaki Ohno

  4. University of Belo Horizonte, Belo Horizonte, Brazil

    Fernando Orefice

  5. USC Eye Institute, University of Southern California, Los Angeles, California, USA

    Narsing A. Rao

1 Electronic Supplementary Material

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Case Report 67

Neuroretinitis (PPTX 7798 kb)

Case Report 81

Neuroretinitis (PPTX 5800 kb)

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London, N.J.S., Cunningham, E.T. (2016). Neuroretinitis. In: Zierhut, M., Pavesio, C., Ohno, S., Orefice, F., Rao, N. (eds) Intraocular Inflammation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75387-2_47

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  • DOI: https://doi.org/10.1007/978-3-540-75387-2_47

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