Clinical and angiographic characteristics of retinal manifestations in catscratch disease

Purpose: To elucidate clinical and angiographic features of retinal manifes tations in cat scratch disease. Methods: Clinical characteristics as well as fluorescein and indocyanine gr een (ICC) angiographic features were reviewed in 4 consecutive patients wit h retinal manifestations caused by serologically confirmed cat scratch dise ase. Results: A subretinal to intraretinal granuloma at the upper margin of the optic disc was found in 3 patients, while 1 patient developed subretinal to intraretinal granuloma in the midperiphery with serous retinal detachment. Fluorescein angiography revealed the abnormal vascular network of the peri papillary granuloma in the early phase followed by its dye leakage toward t he late phase. Indocyanine green angiography demonstrated more clearly the abnormal vascular network with its minimal dye leakage than did fluorescein angiography. In contrast, only the late dye leakage was noted front granul oma of the midperipheral fundus by fluorescein angiography in one patient. Indocyanine green angiography detected no choroidal lesions other than the retinal lesions delineated by fluorescein angiography. The granulomas disap peared in response to a 4-week course of sulfamethoxazole-trimethoprim comb ined with steroids. Conclusions: Granuloma with abnormal vascular network as revealed by fluore scein and ICG angiography is characteristic of retinal manifestations in ca t scratch disease. Jpn J Ophthalmol 2000; 44:182-186 (C) 2000 Japanese Opht halmological Society.