Presumed Tubercular Multifocal Choroiditis

To report a case of tubercular choroiditis that was initially treated for multifocal choroiditis.

A 54-year-old female patient diagnosed with multifocal choroiditis was referred to the clinic while undergoing treatment with systemic prednisone and methotrexate. The presenting visual acuity was 20/100 in the right eye and finger counting at 1 meter in the left eye. Further investigation by repeated tuberculin skin test and QuantiFERON-TB Gold test revealed tuberculosis as the probable cause of choroiditis. The patient was started on a four-drug antituberculosis regimen. Six months later, the vision improved significantly to 20/30 in the right eye and finger counting at 6 meters in the left eye, with no remaining cellular reaction.

Tuberculosis should be considered in the differential diagnosis of multifocal choroiditis, and it is vital to perform careful history taking and thorough examinations.