At initial presentation, our patient showed optic nerve edema clinically with inner retinal hyperreflective retinitis and an overlying vitritis on OCT.
A few weeks later the optic nerve and retinal inflammation improved with the development of a classic lipid star.
The lipid, which leaks out of inflamed optic nerve vessels, accumulates in the outer plexiform layer. Since it originates from the nerve, the star is usually most prominent in the nasal macula.
Learning Points:
Neuroretinitis can be infectious or idiopathic. The most common infectious cause is secondary to Bartonella Henselae (Cat-Scratch Disease).
