Primary Tubercular Chorioretinitis Without a Pulmonary Focus: A Case Report.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• Ocular tuberculosis (TB) is an extrapulmonary manifestation of Mycobacterium tuberculosis.
• It can affect various ocular structures and may present independently of systemic disease.
• Diagnosis of extrapulmonary TB, including ocular involvement, poses significant clinical challenges, particularly in resource-limited settings.

Observation:

• A 33-year-old female presented with progressive vision loss in her left eye.
• Diagnostic workup included neurological examination, serological tests, tuberculin skin test, chest CT, fundus photography, and optical coherence tomography.
• Clinical features and test results led to a presumptive diagnosis of ocular TB.

Findings:

• Antitubercular therapy resulted in marked visual improvement within a week.
• The case demonstrated a rare and atypical presentation of extrapulmonary TB as tubercular chorioretinitis.
• Diagnosis was achieved in a resource-limited setting, highlighting diagnostic adaptability.

Implications:

• This case underscores the importance of considering ocular TB in cases of unexplained vision loss, even in areas with lower TB prevalence.
• It emphasizes the need for enhanced diagnostic capacity and awareness for extrapulmonary TB in resource-limited environments.
• The unusual presentation serves as a valuable learning case for clinicians managing ocular inflammatory conditions.