Clinical improvement of neuroretinitis over six-month follow-up period in an adult patient: a case report

Background. Neuroretinitis is inflammation of the anterior optic nerve and peripapillary retina, presenting with vision loss, optic disc swelling, and a macular star. We report a case of neuroretinitis, the management provided, and the visual outcome. Case report. A 24-year-old man presented with a two-week history of blurry vision and fever. He lived with an unvaccinated cat. Examination revealed visual acuity of counting fingers at 2 meters in the left eye, optic disc swelling, a macular star, and a cecocentral scotoma. Laboratory tests were positive for IgG antibodies to cytomegalovirus (CMV) and rubella, indicating prior exposure. While CMV and rubella were considered possible causes, no definitive etiology was established. Treatment with high-dose corticosteroids led to gradual improvement in visual acuity, reaching 5/5 in both eyes, with resolution of the macular star over six months. A diagnosis of neuroretinitis, likely post-viral in origin, was made. Conclusions. Neuroretinitis is often triggered by infectious or post-viral autoimmune mechanisms. Treatment with methylprednisolone can result in significant clinical improvement.