Dr.Rathinam Sivakumar R
Ocular tuberculosis is often a diagnostic challenge and prompt treatment can save the vision. We report a 17 year old male, a known case of pulmonary TB and tuberculoma of brain for which he completed ATT, giving history of progressive, painless loss of vision in left eye for 1 year. On examination, his best corrected visual acuity was 6/60 in left eye. The fundus of left eye showed a well circumscribed elevated subretinal mass of size 2 disc diameters superotemporal to fovea. It was confirmed with SD-OCT. His right eye was normal. Since the lesion was involving macula, it is impractical to obtain tissue biopsy to demonstrate AFB in smear or culture. Our differential diagnosis was relapse of TB with tubercular choroidal granuloma in left eye. He was restarted on ATT along with tapering dose of oral prednisolone. At the end of 1 year of regular follow up, we found reduction in the size of the mass with BCVA of 6/36 and ATT was stopped. Repeat SD-OCT 3 years later confirmed the same.
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