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Presumed Ocular tuberculosis masquerading as autoimmune retinopathy
Si-Meng Hou1,2, Qian Liu3,2, Xiao-Hui Zhang3,2
1Department of Retina, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
American Journal of Ophthalmology Case Reports
|March 27, 2025
Summary
This case highlights tuberculosis (TB) infection presenting as autoimmune retinopathy (AIR). Prompt diagnosis and treatment of TB led to vision recovery, emphasizing the need to rule out infections before diagnosing AIR.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Autoimmune retinopathy (AIR) is a rare condition causing progressive vision loss.
- Intraocular tuberculosis (TB) can present with diverse ocular manifestations.
Observation:
- A 36-year-old male with blurred vision and visual field constriction was initially suspected to have AIR.
- Steroid treatment worsened his condition, prompting further investigation.
- He was diagnosed with TB infection and treated with anti-tuberculosis therapy (ATT).
Findings:
- Multimodal imaging initially suggested AIR-like retinopathy.
- The patient's condition improved significantly after ATT and subsequent steroid treatment.
- Macular anatomy was restored, and visual function was enhanced post-treatment.
Implications:
- Intraocular TB should be considered in the differential diagnosis of AIR.
- Ruling out active infections is crucial before diagnosing AIR to ensure appropriate management.
- Early diagnosis and treatment of intraocular TB can prevent irreversible vision loss.
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