Visual outcomes and etiologic distribution of neuroretinitis: a 12-year retrospective study from a tertiary eye center

Abstract

Neuroretinitis (NR) is a distinct optic neuropathy characterized by optic disc edema and macular exudates. Whether visual prognosis differs among etiologic subgroups remains unclear. This study aimed to retrospectively evaluate the demographic characteristics, etiologic distribution, and treatment outcomes of patients diagnosed with NR. We retrospectively reviewed NR cases diagnosed between January 2010 and August 2022 at a tertiary referral center. Demographic data, etiologic work-up results, treatment modalities, and visual outcomes were analyzed. Fifty-eight episodes in 34 patients (mean age: 38.3 ± 12.3 years; F/M ratio: 1.25:1) were evaluated. Twenty-five patients had unilateral and nine had bilateral involvement; eight experienced recurrences. Initial visual acuity ranged from 3.0 to 0.1 logMAR (mean ± SD: 0.81 ± 0.64), and final visual acuity ranged from 2.0 to 0 logMAR (mean ± SD: 0.27 ± 0.42).Etiologies included Bartonella ( n = 9), Toxoplasma ( n = 9), Borrelia ( n = 3), Brucella ( n = 2), and Behçet’s disease ( n = 1); ten cases were idiopathic. Mean initial/final visual acuities were 0.45/0.02 logMAR (antibiotics only), 0.58/0.06 logMAR (antibiotics + oral steroids), 0.62/0.08 logMAR (pulse steroids + antibiotics), and 0.79/0.44 logMAR (steroids only), respectively. Infectious agents accounted for a high proportion of NR cases in our cohort, underscoring the need for comprehensive etiologic investigations. Despite appropriate antibiotic therapy, recurrences may occur. Steroid administration without concurrent antimicrobial treatment may adversely affect visual prognosis.