Tuberculous choroidal granulomas in a patient with systemic lupus erythematosus. A case report

We report a case of tuberculous choroidal granulomas in a patient with systemic lupus erythematosis (SLE) who developed miliary tuberculosis (TB) and bilateral granulomas while on immunosuppressive medication.

The case notes of this patient were reviewed.

The patient was first seen for base-line ophthalmic screening before anti-tuberculous medication was started. The patient was subsequently followed up at 2 weeks, 4 weeks and 2 months with fundal examination and photography. One choroidal granuloma was found in the right eye while another peripheral lesion involved the left eye. Both resolved in response to anti-tuberculous medication over a 2-month period with resultant chorioretinal atrophy and scarring.

This case demonstrates the need to screen immuno-suppressed SLE patients who have miliary TB for possible eye involvement.