Atypical Epiretinal Proliferation in a Case of Tuberculosis Uveitis

To report an unusual epiretinal proliferation (EP) case in tubercular serpiginous-like choroiditis.

A 30-year-old female patient with a history of uveitis presented with blurry vision and floaters for 5 days. The visual acuities of the right and left eyes were 7/10 and 9/10, respectively. A slit lamp examination of the right eye showed moderate anterior uveitis with anterior chamber cells of 2+ and 1+ cells in the anterior vitreous. The left eye showed a posterior synechia at the inferior half of the pupil but no cells in the anterior chamber. Mild vitritis was observed in both eyes. A fundus examination revealed two atrophic punch-out lesions in the right eye and multiple pigmented chorioretinal scar-like lesions in the left eye. OCT showed cystoid macular edema in the right eye and a wide epiretinal proliferative membrane in the left eye. The immunocompetent patient had a family history of tuberculosis (TB) infection. The tuberculin skin test resulted in a ≥ 20-mm induration, and the QuantiFERON-TB Gold test was positive. The patient was started on topical and oral steroids. Additionally, anti-TB treatment was added, leading to a favorable outcome. Following treatment, signs of panuveitis showed resolution, and there was an improvement in vision symptoms.

To our knowledge, this may represent one of the first reported cases of EP associated with tubercular serpiginous-like choroiditis.