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Tuberculous Uveitis Presenting with a Bullous Exudative Retinal Detachment: A Case Report and Systematic Literature Review

Authors
Song, JH; Koreishi, AF; Goldstein, DA
Citation
Ocular immunology and inflammation, 27(6). : 998-1009, 2019
Journal Title
Ocular immunology and inflammation
ISSN
0927-39481744-5078
Abstract
PURPOSE: To describe tuberculous uveitis (TU) presenting as a bullous retinal detachment (RD) and to perform a comprehensive literature review on TU with similar features.
METHODS: Observational case report and systematic literature review.
RESULTS: An 84-year-old woman presented with bilateral granulomatous uveitis and bullous RD in the left eye. The interferon gamma release assay was strongly positive, but all other tests were unremarkable. The patient was diagnosed with TU and started on anti-tubercular therapy (ATT) and systemic steroids with excellent treatment response. Twenty-six articles (32 cases) reported TU with exudative RD. Choroidal tuberculoma was the most common clinical manifestation, followed by optic disc edema and retinal exudate. Systemic steroids with ATT improved vision in more patients (78.6%) than ATT alone (50.0%) or oral steroids followed by ATT (50.0%).
CONCLUSION: Atypical presentations of TU make diagnosis and treatment difficult. A high level of suspicion for TU is needed to minimize ocular morbidity.
Keywords
Anti-tubercular therapychoroiditisocular tuberculosisretinal detachmenttuberculosisuveitis
MeSH terms
Aged, 80 and overAntitubercular Agents / therapeutic useFemaleFluorescein AngiographyGranuloma / diagnosisGranuloma / drug therapyGranuloma / microbiologyHumansInterferon-gamma Release TestsMycobacterium tuberculosis / isolation & purificationRetinal Detachment / diagnosis*Retinal Detachment / drug therapyRetinal Detachment / microbiologyTuberculosis, Ocular / diagnosis*Tuberculosis, Ocular / drug therapyTuberculosis, Ocular / microbiologyUveitis / diagnosis*Uveitis / drug therapyUveitis / microbiology
DOI
10.1080/09273948.2018.1485958
PMID
29969330
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Ophthalmology
AJOU Authors
송, 지훈
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