title: Presumed latent ocular tuberculosis diagnosed with the positive quantiFERON-TB Gold In-Tube Test in a HLA-A29-positive patient.
abstract: A 59-year-old Hispanic woman presented with a 3-year history of floaters associated with bilateral reduced visual acuity. Her best-corrected visual acuity (BCVA) was 20/40. Both anterior segments were without inflammation, but fundoscopy showed mild vitreous inflammation and multiple inflammatory choroidal lesions. Tests for inflammatory and infectious diseases were negative except for human leucocyte antigen A29. The patient was diagnosed with birdshot choroidoretinopathy, and treatment was initiated with cyclosporine A 2.5 mg/kg/day. One year after treatment, the patient reported systemic symptoms with no improvement in visual acuity. Fundus findings remained with vitreal inflammation. QuantiFERON-TB Gold In-Tube Test was positive, and a diagnosis of presumed latent ocular tuberculosis (TB) was made. We initiated anti-TB treatment for 9 months. At 6 months of anti-TB therapy, there was no active inflammation. The patient was followed for 2 years with no medications and no active inflammation. Her final BCVA was 20/25.
authors.affiliation: Instituto Universitario Fernández-Vega, Universidad de Oviedo, Spain Fundación Oftalmológica de Santander, Universidad Autónoma de Bucaramanga, Colombia, Cartagena, Bolivar, Colombia.
authors.forename: Carlos Mario
authors.initials: CM
authors.lastname: Rangel
authors.affiliation: Instituto Universitario Fernández-Vega, Universidad de Oviedo, Spain Clínica Oftalmológica de Cartagena, Universidad del Sinu, Cartagena, Colombia.
authors.forename: Cesar
authors.initials: C
authors.lastname: Atencia
authors.affiliation: Instituto Universitario Fernández-Vega, Universidad de Oviedo, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Merayo-Lloves
authors.affiliation: Instituto Universitario Fernández-Vega, Universidad de Oviedo, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Fernandez-Vega Sanz
mesh_terms: D005260:Female; D005654:Fundus Oculi; D006046:Gold; D015234:HLA-A Antigens / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D008875:Middle Aged; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*
chemical_list: D015234:HLA-A Antigens; C035524:HLA-A29 antigen; D006046:Gold