Optic disk edema associated with peripapillary serous retinal detachment:: An early sign of systemic Bartonella henselae infection

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection. METHODS: Multicentered, retrospective case series. RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment, Each patient had a markedly elevated serum anti-B, henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients, Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better, CONCLUSIONS: Systemic B, henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star. (C) 2000 by Elsevier Science Inc. All rights reserved.