Overview
Neuroretinitis is an inflammatory condition of the posterior segment. It is characterised by unilateral (sometimes bilateral) disc oedema with associated exudation that causes the formation of a macular star.
It may have an infectious cause, the most common of which is cat scratch disease caused by Bartonella henselae. It may also have non-infectious causes which includes underlying systemic inflammatory conditions. Some cases however have no identifiable cause and are considered idiopathic. These are most commonly episodic with recurrence in some patients, in which case they are associated with a poor visual prognosis.
Neuroretinitis is usually preceded by a febrile illness including symptoms of headache, rash and lymphadenopathy. Reduced vision and a caecocentral/central scotoma are noted, and a relative afferent pupillary defect (RAPD) is typically present.
Clinically, swelling of the optic nerve head is noted followed by formation of a macula star. White retinal lesions and vitritis may follow up to weeks later.
Most cases spontaneously resolve with disc oedema starting to subside after 2 weeks and complete recovery by 3 months.
Differential Diagnosis
References
Abdelhakim, A. Rasool, N. (2018) Neuroretinitis, Current Opinion in Ophthalmology: November 2018 - Volume 29 - Issue 6 - p 514-519