Serous macular detachment of the neuro‐epithelium in patient with tuberculous choroidal granuloma.

Abstract

AbstractPurpose To describe an interesting serous macular detachment of the neuro‐epithelium in a patient with tuberculous choroidal granuloma. Setting : Choroidal tubercles are a common manifestation of ocular tuberculosis and represent a direct mycobacterial infection of the choroid.Methods A 41 year old man complained of blurred vision in his right eye over the past 5 days. His brother was recently treated for pulmonary tuberculosis. Visual acuity in the right eye was 20/40 and in the left eye 20/20. The intraocular pressure was 12 mmHg in RE and 10 mmHg LE. Fundus examination of the right eye showed an active tuberculous choroidal granuloma. Fundus examination of the left eye was normal. The OCT of the right eye showed a serous macular detachment of the neuro‐epithelium. The tests were positive for tuberculosis.Results The patient underwent a specific treatment for tuberculosis. At 3‐months follow‐up, the visual acuity in both eyes was 20/20. Fundus examination showed a complete resolution of the tuberculous choroidal granuloma and of the serous macular detachment of the neuro‐epithelium.Conclusion Ocular tuberculosis may occur in the absence of systemic clinical activity and may mimic several clinical entities. In some cases, the ophthalmologic exams are very important for the early diagnosis to avoid systemic complications.