Article Figures & Data
Figures
- Fig 1.
The fundoscopic photograph shows the characteristic macular star formation composed of very small bright spots (arrows) to the right of optic nerve disk and aligned in a stellar configuration.
- Fig 2.
20-year-old woman with most extensive imaging findings of optic neuropathy due to cat scratch fever (patient 3, Table 2).
A and B, Axial (A) and coronal (B) gadolinium-enhanced fat-suppressed T1-weighted images (TR1, TR2/TE, 735, 850/14) show significant bulging of the right optic disk (arrow, A) associated with severe enhancement at the optic nerve–globe junction (arrow, A and B). Note the normal appearance of the optic nerve–globe junction on the left (arrowhead, A and B).
- Fig 3.
17-year-old girl with moderate imaging findings of optic neuropathy due to cat scratch fever (patient 4, Table 2).
A and B, Axial (A) and coronal (B) gadolinium-enhanced fat-suppressed T1-weighted images (TR1, TR2/TE, 735, 875/14) show bulging of the left optic disc (arrow, A) that is markedly less pronounced than that on the right (arrowhead, A) as well as that in Figure 1. The associated enhancement at the left optic nerve–globe junction (arrow, A and B) is also markedly less extensive. Note the normal appearance of the optic nerve–globe junction region on the right (arrowhead, A and B).
- Fig 4.
42-year-old woman with very subtle imaging findings of optic neuropathy due to cat scratch fever (patient 5, Table 2).
A and B, Axial (A) and coronal (B) gadolinium-enhanced fat-suppressed T1-weighted images (TR1, TR2/TE, 735, 882/14) show very minimal bulging of the left optic disk (arrow, A) compared with those in Figures 1 and 2. The associated enhancement at the left optic nerve–globe junction (arrow, A and B) is very subtle, in particular in the coronal plane. Note the normal appearance of the optic nerve–globe junction region on the right (arrowhead, A and B).
- Fig 5.
Plot of enhancement in 44 optic nerves (37 patients). Each horizontal line represents the area of enhancement in a single nerve. The distance from zero on the x-axis to the left end of the line represents length (if any) of nonenhancing nerve adjacent to the globe. The length of the line itself represents the extent of enhancement. The 5 enhancing nerves in patients with optic neuropathy due to cat scratch disease are at the bottom (bold lines). The other 39 enhancing nerves with optic neuropathy from other causes are above these (thin lines). The one patient with false-positive findings is marked as a short thin line just above the patients with cat scratch disease.
Tables
- TABLE 1:
Summary of final diagnosis and demographic data of all enrolled patients with optic neuropathy
Final Diagnosis No. of Patients (%) Average Age (yr) Sex (Female/Male) Idiopathic optic neuropathy 42 (51.2) 44.2 28/14 Ischemic optic neuropathy 18 (22.0) 59.8 12/6 Optic neuropathy related to cat scratch disease 9 (11) 31.7 5/4 Optic neuropathy related to multiple sclerosis 9 (11) 42.0 9/0 Others (sarcoidosis, radiation-induced, due to compression by tumor or giant cell arteritis) 4 (4.9) 63.7 1/3 - TABLE 2:
Demographic data clinical findings, and laboratory results of patients with optic neuropathy due to cat scratch disease
Pation No. Age Sex IgM IgG Symptom Duration (weeks) Macular Exudate MRI Cats at Home 1 41 F — 64 1 No (initially) + Yes Yes (on follow-up) 2 28 M 128 1024 2 No (initially) + Unknown Yes (on follow-up) 3 20 F — 1024 2 No (initially) + Unknown Yes (on follow-up) 4 17 F — 256 6 Yes + Yes 5 42 F — 64 12 No + Unknown 6 23 M — 64 1 No (initially) − Unknown Yes (on follow-up) 7 32 F 128 128 0.5 No − Yes 8 66 F 34 1024 4 No − Yes 9 17 M — 128 22 No − Yes Final Diagnosis Optic Nerve Enhancement (%) Average Extent of Enhancement (mm ± SD) Optic Nerve Edema and Enhancement (%) Optic Nerve Edema without Enhancement (%) White Matter Lesions and Optic Nerve Enhancement (%) Idiopathic optic neuropathy 21/42 19.6 ± 9.3 21/21 5/42 12/21 (50.0) (100) (11.9) (57) Ischemic optic neuropathy 2/18 21.5 ± 18.5 1/2 2/18 1/2 (11.1) (50) (11.1) (50) Optic neuropathy related to cat scratch disease 5/9 3.58 ± 0.48 0/5 0/9 0/5 (55.6) (0) (0) (0) Optic neuropathy to multiple sclerosis 6/9 17.95 ± 9.9 5/6 0/9 4/6 (66.7) (83.3) (0) (66.7) Others 3/4 10.7 ± 9.8 3/3 1/4 1/4 (75) (100) (25) (25)
