Subretinal fluid analysis in the diagnosis of choroidal tuberculosis.
BACKGROUND
Diagnosis of intraocular tuberculosis is often difficult. A choroidal granulomalike lesion suspected to be the result of tuberculosis could be of other inflammatory, infective, or neoplastic causes. We report two cases in which a choroidal granuloma with exudative retinal detachment was diagnosed as tuberculosis by the detection of acid-fast bacilli in subretinal fluid.


METHODS
Interventional case series.


RESULTS
Two female patients had choroidal granulomas with surrounding exudative retinal detachment. Detailed laboratory investigations were unhelpful in diagnosis, and the patients' conditions worsened with systemic steroid therapy. Subretinal fluid was tapped and revealed acid-fast bacilli and grew Mycobacterium tuberculosis on culture.


CONCLUSIONS
Subretinal fluid analysis can help in the detection of tuberculous granuloma and facilitate successful management.
Salman
Amjad
A
Department of Ophthalmology, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli, India. amjad26@sify.com
Parmar
Pragya
P
Rajamohan
M
M
Thomas
Philip A
PA
Jesudasan
Nelson
N
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001826:Body Fluids / Q000382:microbiology*; D015862:Choroid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D004359:Drug Therapy, Combination; D005122:Exudates and Transudates / Q000382:microbiology*; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012163:Retinal Detachment / Q000175:diagnosis / Q000382:microbiology; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
D000995:Antitubercular Agents