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TitleUveitis associated with bilateral serous retinal detachment and septae is not only Vogt-Koyanagi-Harada disease
PurposeTo report a rare case of presumed tuberculosis uveitis presenting as bilateral serous retinal detachment and septae simulating Vogt-Koyanagi-Harada (VKH) disease.
MethodsCase series and review of literature.
ResultsA 56-year-old woman presented with bilateral diminution of vision and floaters in both the eyes. Initial best corrected visual acuity (BCVA) was 20/1000. Both eyes had disc oedema, multiple pockets of serous retinal detachments along without vitritis. Fluorescein angiography and optical coherence tomography (OCT) showed characteristic features of Vogt-Koyanagi-Harada (VKH) syndrome, especially with SRD and septae in OCT. Before starting high-dose corticosteroid and immunosuppressive treatement, . Mantoux tuberculin skin test showed an area of induration measuring 13 mm and a positive interferon-gamma release assay was documented. The diagnosis of VKH was re considered. She started a full standard course of 4-drug antitubercular therapy. SRD started to resolve and showed a favourable reponse to treatment. After 21 days of treatement, BCVA improved to 20/32 and the treatment was continued.
ConclusionOcular tuberculosis can have features similar to VKH. Hence it is important not to misdiagnose tuberculosis and to treat directelly by immunosuppressive therapy without screening tuberculosis.
Conflict of interestNo
Author 1
Last nameMILI-BOUSSEN
Initials of first name(s)I
DepartmentDepartment of Ophthalmology. Charles Nicolle University Hospital of Tunis
CityTunis
CountryTunisia
Author 2
Last nameBOUKARI
Initials of first name(s)M
CityTunis
CountryTunisia
Author 3
Last nameKAOUEL
Initials of first name(s)H
CityTunis
CountryTunisia
Author 4
Last nameBRAHAM-ZHIOUA
Initials of first name(s)I
CityTunis
CountryTunisia
Author 5
Last nameAMMOUS
Initials of first name(s)I
CityTunis
CountryTunisia
Author 6
Last nameERRAIS
Initials of first name(s)K
CityTunis
CountryTunisia
Author 7
Last nameZHIOUA
Initials of first name(s)R
CityTunis
CountryTunisia