title: Paradoxical worsening of tuberculous chorioretinitis in a Chinese gentleman.
abstract: We report a case of paradoxical worsening of tuberculous chorioretinitis after initiation of anti-tuberculous therapy (ATT). The patient had left panuveitis with tuberculous chorioretinitis and was started on systemic ATT and oral steroids a week later. However, he developed paradoxical worsening 2 months after initiation of therapy. He was continued on ATT, oral steroids and intravitreal amikacin with resolution of the chorioretinal lesion subsequently. Ocular tuberculosis often poses a diagnostic challenge, and clinicians should be aware of the possibility of paradoxical worsening despite appropriate ATT. Clinicians should strongly consider starting oral steroids concurrently with ATT when managing ocular tuberculosis.
authors.affiliation: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, 308433 Singapore.
authors.forename: Rosalynn Grace
authors.initials: RG
authors.lastname: Siantar
authors.affiliation: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, 308433 Singapore.
authors.forename: Su Ling
authors.initials: SL
authors.lastname: Ho
authors.affiliation: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, 308433 Singapore.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Agrawal
keywords: Chorioretinitis; Ocular tuberculosis; Paradoxical worsening; Steroids