Neuroretinitis: Diagnostic Associations and Management Approach.

Purpose: To describe the clinical presentation, management, visual outcomes, and prognosis of neuroretinitis in a cohort who had neuroretinitis associated with different etiologies.

Methods: A retrospective review of the medical records of 10 patients diagnosed with neuroretinitis from a period of 2014 to March 2024 and reporting the clinical features, management, and prognosis.

Results: The study included 12 eyes from 10 patients. Seven were males and three were females. The mean age on presentation was 26.5 ± 12.8 years. The Mean duration of follow up was 15.25 ± 14.3 months. The Mean LogMAR visual acuity on presentation was 0.4 ± 0.4 (Snellen = 20/50). Six patients were diagnosed with Behcet's disease, one patient with ocular cat-scratch disease, one patient diagnosed with ocular toxoplasmosis and two patients had idiopathic neuroretinitis. Three patients were initially treated with intravenous methylprednisolone, 5 patients were treated with oral prednisolone, one patient was treated with oral doxycycline and one patient was treated with oral sulfamethoxazole/trimethoprim. The average duration for resolution of first attack was 1.2 ± 0.6 months. Three patients who were diagnosed with Behcet's disease had recurrent neuroretinitis for which treatment regimens were modified. The mean visual acuity on last follow-up was 0.1 ± 0.2 (Snellen = 20/25).

Conclusion: Proper management of neuroretinitis involves establishing the accurate diagnosis. In cases with neuroretinitis due to Behcet's disease, the TNFa inhibitors need to be initiated as early as possible to achieve better control and reduce the risk of recurrent attacks of neuroretinitis.