Zeitschrift für klinische und experimentelle Ophthalmologie
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Bartonella Neuroretinitis: A Case Report with New Insights from Fundus Autofluorescence Imaging

Justin JY Yamanuha and Mihai Mititelu

Purpose: Fundus autofluorescence (FAF) is a modern functional imaging modality utilized to characterize abnormalities of the retinal pigment epithelium (RPE). There are no prior studies demonstrating FAF findings in both symptomatic and asymptomatic eyes of patients diagnosed with Bartonella neuroretinitis.
Methods: Case report and review of the literature.
Patients: Single patient case study. Results: In the symptomatic right eye, (FAF-Heidelberg Retina Angiograph; Heidelberg Engineering, Heidelberg, Germany) identified abnormality of the RPE which corresponded to pathology seen on fundus photography, fluorescein angiography (FA-Heidelberg Retina Angiograph; Heidelberg Engineering, Heidelberg, Germany) and spectral domain optical coherence tomography (SD-OCT-Spectralis®, Heidelberg Engineering, Heidelberg, Germany). Interestingly, FAF also demonstrated sub-clinical anatomic abnormalities not seen clinically nor detected as clearly by any other imaging modalities in the patient’s asymptomatic left eye. As the patient improved clinically, normalization of the FAF occurred in both eyes.
Discussion: This report is the first study to describe novel subclinical and clinical FAF findings as part of the evaluation of a patient with infectious neuroretinitis. Compared to FA, SD-OCT and clinical examination, FAF provided a more detailed functional understanding of this condition in its early stages and was also used to follow the clinical course of this patient. This functional imaging modality confirmed normalization of anatomic abnormalities also demonstrated by the other techniques.