Tubercular serpiginous-like choroiditis.
Choroidal tuberculosis (TB) infection may present itself as a diffuse choroiditis that resembles serpiginous choroiditis, usually treated with immunossupressants. Recent studies have demonstrated that patients with serpiginous-like choroiditis and evidence of systemic or latent TB are best treated with antituberculosis treatment (ATT) in addition to the corticosteroid therapy. The authors present a case of a 58-year-old man with decreased vision in his left eye. His best-corrected visual acuity was 20/20 right eye and 20/200 left eye. Funduscopic examination revealed a diffuse choroiditis. Mantoux skin test showed an area of induration measuring 30×35 mm and the patient started ATT with complete resolution of retinal lesions after 2 weeks of treatment. His final visual acuity was 20/25 in the left eye with no recurrences over a follow-up of 6 months. The use of ATT in these patients is likely to reduce active inflammation and eliminate future recurrences.
Ophthalmology Department, Hospital Egas Moniz, Lisbon, Portugal. marta.ce.guedes@gmail.com
Marta Esteves
ME
Guedes
José Nuno
JN
Galveia
Ana Catarina
AC
Almeida
João Marques
JM
Costa
D000995:Antitubercular Agents / Q000627:therapeutic use*; D002833:Choroiditis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D004338:Drug Combinations; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011718:Pyrazinamide / Q000627:therapeutic use*; D012293:Rifampin / Q000627:therapeutic use*; D014392:Tuberculosis, Ocular / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D014786:Vision Disorders / Q000382:microbiology
D000995:Antitubercular Agents; D004338:Drug Combinations; C087181:isoniazid, pyrazinamide, rifampin drug combination; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin