Atypical central serous retinopathy in a patient with latent tuberculosis

A 32-year-old Afro-Caribbean male presented with a 4 month history of blurred vision and distortion in his right eye. Fundus examination showed multiple pigment epithelial detachments which progressed over 2 months of observation to a large serous detachment of the macula. Fundus fluorescein angiography (FFA) showed multi-focal hyperfluorescence in the early phase which increased in the later stages. A diagnosis of multi-focal central serous retinopathy (CSR) was made. Due to the size of CSR and atypical findings on FFA further investigations including a T-spot test were performed. The T-spot test was reported as strongly positive and following discussion with the respiratory physicians he was started on empiric antituberculous therapy. Over the next 6 weeks, the patient had a significant visual improvement to 6/9 with resolution of the serous detachment.