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Serpiginoid choroiditis associated with presumed ocular tuberculosis.
Te-An Wang1, Kang-Jung Lo2, De-Kuang Hwang2,3
1Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
Taiwan Journal of Ophthalmology
|June 15, 2019
Summary
This study shows serpiginoid choroiditis can indicate ocular tuberculosis. Prompt treatment with antituberculosis therapy successfully controlled inflammation and stabilized lesions in a patient.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Ocular tuberculosis diagnosis is challenging.
- Serpiginoid choroiditis can present as a manifestation of intraocular inflammation.
Observation:
- A 63-year-old female presented with progressive bilateral blurred vision and was diagnosed with serpiginoid choroiditis.
- Fundus examination revealed diffuse patchy geographic retinal pigment epithelium (RPE) changes and retinal vasculitis.
- Fluorescein angiography showed leakage from RPE lesions and discs.
Findings:
- A positive QuantiFERON-TB Gold test supported a diagnosis of ocular tuberculosis.
- Systemic antituberculosis treatment led to improvement in uveitis and stabilization of chorioretinal lesions.
- The patient completed a 12-month course of treatment with no recurrence of uveitis.
Implications:
- Serpiginoid choroiditis may be an indicator of ocular tuberculosis.
- Interferon-gamma release assay (IGRA) tests and response to antituberculosis therapy aid in diagnosing tubercular uveitis.
- Clinicians should consider tuberculosis in patients presenting with serpiginous-like retinal findings.
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