Leber's Idiopathic Stellate Neuroretinitis Research Articles

Profil clinique et étiologique des neurorétinites aiguës dans le sud tunisien

The diagnosis of neuroretinitis is clinical, with optic nerve involvement and a macular star. The most common etiology is cat scratch disease. Study of 7 patients (7 eyes) with neuroretinitis. A complete ophthalmic examination, fluorescein angiography and optical coherence tomography were performed for all patients. A focused etiological work-up was conducted. The mean age of the patients was 41.6 years [27-51 years]. Decreased visual acuity was the most common reason for consultation. The neuroretinitis was unilateral in all cases. Subclinical serous retinal detachment was noted in 5 patients. The common etiologies were rickettsiosis (4 cases) and tuberculosis (1 case). Leber's idiopathic stellate neuroretinitis was concluded by the negativity of the etiological investigation. Doxycycline was the treatment of choice for rickettsiosis. Rickettsiosis appears to be more common than cat scratch disease as an etiology of neuroretinitis in the present study in southern Tunisia. Moreover, the clinical association of a serous retinal detachment, rarely reported in the literature, seems to be more frequent in our series.

Neurorretinitis estrellada idiopática de Leber: conflictos diagnósticos y terapéuticos

Three cases of patients with decreased visual acuity and papillitis at onset with subsequent macular star development after a few weeks are presented. Complementary tests were unremarkable in all included patients. Based on this clinical context, they were diagnosed with Leber's idiopathic stellate neuroretinitis, were treated with corticosteroids, as well as with antibiotics in 2cases. All patients showed favourable outcomes, although signs of papillary atrophy were observed in the affected eyes.Leber's idiopathic stellate neuroretinitis diagnosis can be challenging due to the wide spectrum of conditions that have to be ruled out. In addition, macular star may appear later on, which should not exclude its diagnosis. Use of antibiotics and/or corticosteroids is controversial considering its benign nature, but should be considered in selected severe cases. Moreover, the routine use of complementary tests should be carefully evaluated, mainly those that can be aggressive and/or expensive, which should be rationally used.

Intravitreal Bevacizumab Injection for Serous Retinal Detachment Associated with Leber's Idiopathic Stellate Neuroretinitis

Intravitreal Bevacizumab Injection for Serous Retinal Detachment Associated with Leber's Idiopathic Stellate Neuroretinitis

Infrared imaging of choroidal involvement in Leber’s idiopathic stellate neuroretinitis

PurposeLeber’s idiopathic stellate neuroretinitis (LIN) is a rare condition that has been always considered an inflammatory disease, with emphasis given to the optic disc and neuroretina alterations.MethodsA healthy 54-year-old woman presented a sudden loss of vision in the left eye, referring to periocular pain, headache, and mild fever for 1 month. Tests of best-corrected visual acuity, optical coherence tomography, infrared (IR) filter, fluorescein, and indocyanine green angiography were performed at the follow-up.ResultsThe patient submitted to IR imaging, which revealed diffuse patchy choroidal infiltrates involving the posterior pole midperiphery, which were still present after 3 years of follow-up.ConclusionIn this observation, we reported that choroidal involvement may occur in LIN. The IR filter is an important and noninvasive tool able to distinguish and follow choroidal infiltrates to better delineate the pathological process and elucidate the nature of the disease.

Retinal Angiography and Optical Coherence Tomography Disclose Focal Optic Disc Vascular Leakage and Lipid-Rich Fluid Accumulation Within the Retina in a Patient With Leber Idiopathic Stellate Neuroretinitis

A 52-year-old woman with clinical features of Leber idiopathic stellate neuroretinitis (LISN) underwent retinal fluorescein and indocyanine green angiography that revealed lipid-containing fluid leakage from a single arteriole in the superficial nerve fiber layer of the optic disc. The fluid expanded gradually into the upper half of the optic disc and the adjacent peripapillary retina. Optical coherence tomography (OCT) demonstrated fluid accumulation in two separate subretinal spaces and in the outer nuclear-plexiform layer, which extended from the optic disc margin to the fovea. These angiographic and OCT findings support the hypothesis that LISN develops from focally increased permeability of an optic disc surface arteriole from which lipid-rich fluid flows through the outer nuclear-plexiform layer space to pool in these retinal areas.

Central Serous Retinal Detachment Detected by Optical Coherence Tomography in Leber's Idiopathic Stellate Neuroretinitis

Leber's idiopathic stellate neuroretinitis (LISN) is characterized mainly by bifocal lesions, namely, optic neuritis and maculopathy with starlike exudates. However, it is unclear how the macular region is involved. 1 - 4 In our patient with LISN, optical coherence tomography (OCT) revealed central serous retinal detachment with exudates in the retinal outer plexiform layer.

Pet-, animal-, and vector-borne infections.

1. Carol Glaser, DVM, MD* 2. Paul Lewis, MD† 3. Stephanie Wong, DVM‡ 1. 2. *Viral and Rickettsial Disease Laboratory, California Department of Health Services, Berkeley, CA. 3. 4. †Assistant Professor of Pediatrics, Division of Infectious Diseases, Oregon Health Sciences University, Portland, OR. 5. ‡Tufts University School of Veterinary Medicine, Grafton, MA. Zoonoses are diseases that can be transmitted from animals to humans. They can be acquired via insect vectors, food, and direct or indirect contact with animals. More than 250 zoonoses have been described, and they are caused by a wide variety of pathogens, including viruses, rickettsia, bacteria, fungi, and parasites. Some of the diseases are rare, such as rabies and plague; others, such as cat-scratch disease, are common. The transmission of zoonotic diseases is both diverse and dynamic. Although illnesses such as salmonellosis and campylobacteriosis are by far the most common zoonotic infections in humans and are transmitted most often by food, there is a small risk of acquiring illness from pets and wildlife. Because many pet- and wildlife-related zoonoses are acquired via fecal-oral or direct contact routes, the inquisitive nature of children puts them at a higher risk for infection than adolescents and adults. It is important for pediatricians to be aware of zoonoses, especially those related to direct pet contact, because approximately 56% of United States households contain at least one pet. Pet ownership has many psychological and social benefits and should not be discouraged, with the exception of households that contain immunocompromised individuals or children younger than age 5 years, which should not have reptiles because of the risk of salmonellosis. This review discusses the epidemiology, animal reservoirs, transmission, clinical syndromes, laboratory features, treatment, and prevention of toxoplasmosis, rabies, cat-scratch disease, Lyme disease, and rat-bite fever. Additionally, brief overviews of animal bites and enteric infections are presented, as are tables on zoonoses related to dogs, cats, rodents, birds, and exotic pets (Table 1⇓ ); animal bite-related zoonoses (Table 2⇓ ); and vector-borne diseases (Table 3⇓ ). View this table: Table 1. Pet-related Zoonoses View this table: Table 2. Animal Bite-related Zoonoses View this table: Table 3. Vector-borne Diseases ### EPIDEMIOLOGY/ETIOLOGY Toxoplasmosis has a worldwide distribution. The seroprevalence in women of childbearing …

Leber’s idiopathic stellate neuroretinitis: Differential diagnosis and approach to management

Leber's idiopathic stellate neuroretinitis (LISN) is a relatively uncommon clinical entity that is characterized by optic disc oedema and associated macular hard exudates. A broad range of causes can produce such a fundus appearance. The clinical experience of the authors is combined with a review of the pertinent literature to describe the features of LISN and its differential diagnosis. A knowledge of the potential causes of neuroretinitis is important in order to formulate an effective management strategy.

Leber's idiopathic stellate neuroretinitis.

Twenty-nine eyes of 27 patients demonstrated the typical features of neuroretinitis with a mascular star. Historical and fluorescein angiographic features of this condition implicate a bloodborne infectious agent. It is likely that multiple agents can produce this condition, including the agent of cat-scratch fever and leptospirosis. A small subgroup may exist in whom this condition resembles anterior ischemic optic neuropathy and has a less favorable clinical course than is usual. There is evidence that this condition is not related to demyelinating disease. It is emphasized that this condition is not a maculopathy since vascular leakage in the optic nerve causes the star. Therefore, we suggest that this condition be renamed Leber's idiopathic stellate neuroretinitis.