Treatment Strategies for Neuroretinitis: Current Options and Emerging Therapies

Aaron M. Fairbanks, Matthew R. Starr, John J. Chen, M. Tariq Bhatti

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Purpose of review: To explore and critically appraise the published data on the current and emerging treatment modalities for neuroretinitis. Recent findings: The optimum treatment strategy for neuroretinitis due to Bartonella henselae in immunocompetent individuals is not clear and a matter of debate. The role of systemic corticosteroids in infectious neuroretinitis and the optimum immunosuppressive regimen for use in recurrent idiopathic neuroretinitis also remains ill defined. Summary: There is no class 1 evidence to support a specific treatment strategy for neuroretinitis. For uncomplicated B. henselae–associated neuroretinitis in immunocompetent patients, initiation of antibiotic and corticosteroid therapy remains controversial. In patients with severe vision loss and/or moderate to severe systemic symptoms, a 4- to 6-week regimen of doxycycline or azithromycin with rifampin may provide some benefit. The routine use of systemic corticosteroids in infectious neuroretinitis is not recommended. Targeted antimicrobial agents should be instituted in cases of neuroretinitis due to specific infectious etiologies (e.g., syphilis, Lyme disease, tuberculosis). Azathioprine may be beneficial in cases of recurrent idiopathic neuroretinitis. There is a need for collaborative, multicenter prospective studies to provide definitive guidelines regarding the use of antibiotics and corticosteroids and to evaluate future therapies in infectious and recurrent idiopathic neuroretinitis.

Original languageEnglish (US)
Article number36
JournalCurrent Treatment Options in Neurology
Volume21
Issue number8
DOIs
StatePublished - Aug 1 2019

Keywords

  • Bartonella
  • Cat scratch optic neuropathy
  • Disc edema
  • Macular star
  • Neuroretinitis

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint Dive into the research topics of 'Treatment Strategies for Neuroretinitis: Current Options and Emerging Therapies'. Together they form a unique fingerprint.

Cite this