Cat scratch disease (CSD) is a systemic illness caused by the gram-negative bacillus, Bartonella henselea, which can occasionally involve the ocular structures. The objective of this study is to evaluate the various clinical presentations of ocular bartonellosis at our institution. A retrospective review of the clinical records of 13 patients (23 eyes) with ocular manifestations of Bartonella infections over a 3-year period between January 2016 to December 2018 was undertaken at our institution. The diagnosis was made based on clinical findings and in addition, with the support of the evidence of Bartonella hensalae IgG and/or IgM. Small retinal white lesions were the most common ocular findings in this series of patients (82.6% of eyes, 76.9% of patients). Neuroretinitis was the second most common finding (47.8% of eyes, 69.2% of patients), followed by exudative retinal detachment involving the macula (34.8% of eyes, 53.8% of patients) and Parinaud’s oculoglandular syndrome (17.4% of eyes, 23.1% of patients). Other findings like isolated optic disc oedema without macular star (8.7% of eyes, 15.4% of patients) and vitritis (4.3% of eyes, 7.7% of patients) were also observed. Ten patients (76.9%) had bilateral ocular involvement. Most of the patients were young, immunocompetent and had systemic symptoms like fever prior to their ocular symptoms. The visual acuity (VA) at initial presentation ranged from 6/6 to hand movement (mean, 6/20), and at final visit 6/6 to 6/60, (mean, 6/9). 91.7% of patients were treated with antibiotics. Only 2 patients received oral corticosteroids together with antibiotics due to very poor vision on presentation. The visual prognosis of ocular bartonellosis is generally good with 16 (88.9%) of 23 eyes having VA of 6/12 or better at final follow-up visit. Small foci of retinal white lesions were the most common manifestation of ocular bartonellosis in this series, followed by neuroretinitis, though an array of other ocular findings may also occur. Therefore, we should consider bartonella infection as a possible differential diagnosis in those patients.

中文翻译：

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眼压病的临床范围：在马来西亚第三大医院的回顾性研究

猫抓伤病（CSD）是由革兰氏阴性杆菌Bartonella henselea引起的全身性疾病，偶尔会涉及眼部结构。这项研究的目的是评估我们机构眼压囊病的各种临床表现。我们机构对2016年1月至2018年12月这3年中13例Bartonella感染的眼部表现的临床记录进行了回顾性研究。诊断是根据临床发现做出的，此外，还得到了汉莎巴尔通体IgG和/或IgM证据的支持。视网膜小的白色病变是该系列患者中最常见的眼部检查结果（占眼睛的82.6％，占患者的76.9％）。神经视网膜炎是第二常见的发现（47.8％的眼睛，69.2％的患者），其次是渗出性视网膜脱离，累及黄斑（34.8％的眼睛，占53.8％的患者）和帕里诺氏耳land综合征（17.4％的眼睛，占23.1％的患者）。还观察到其他发现，如无黄斑星状的单纯性视盘水肿（8.7％的眼睛，患者的15.4％）和玻璃体炎（4.3％的眼睛，患者的7.7％）。十名患者（76.9％）双侧眼受累。大多数患者是年轻的，具有免疫能力的患者，在出现眼部症状之前有全身症状，例如发烧。最初呈现时的视力（VA）为6/6至手部移动（平均值为6/20），而最终访视时的视敏度（VA）为6/6至6/60（平均值为6/9）。91.7％的患者接受了抗生素治疗。由于出现视力很差，只有2例患者接受了口服皮质类固醇激素和抗生素的治疗。眼部Bartonellosis的视觉预后通常良好，在最后的随访中，23眼中有16眼（88.9％）的VA为6/12或更好。视网膜白色病变的小灶是该系列眼压中最常见的表现，其次是神经视网膜炎，尽管也可能出现其他一系列眼部表现。因此，我们应考虑将巴尔通体感染作为这些患者的可能的鉴别诊断。