Cat-scratch disease associated with branch retinal artery occlusion

Purpose: We describe two cases of branch retinal artery occlusion (BRAO) as the presenting sign of cat-scratch disease. Methods and Patients: Case 1 (25-year-old man) presented with decreased vision, visual field changes, a swollen disk, and BRAO. Case 2 (27-year-old woman) presented with decreased vision bilaterally: findings on examination were a macular star figure on the right eye and a BRAO on the left. Results: Both cases clinically improved after a course of systemic antibiotics. Case 1 had a normal optic disk and almost a complete resolution of the ischemic area 4 weeks after treatment. Case 2 had a complete resolution of the BRAO, and her macular exudates and optic disk edema partially resolved 5 weeks after treatment. Conclusion: Cat-scratch disease should be considered in the differential diagnosis of BRAO, especially in young patients. The use of systemic antibiotics in cat scratch neuroretinitis, although proven beneficial in our patients, remains controversial and should probably be reserved for the more severe forms of the disease.