Cystoid macular edema : a rare presentation of presumed tubercular uveitis
Purpose
To report a rare case of presumed tubercular uveitis presenting as cystoid macular edema.
Methods
Case series and review of literature.
Results
A 22-year-old woman presented with bilateral diminution of vision in both the eyes. Initial best corrected visual acuity (BCVA) was 20/200. Both eyes had disc oedema, vitritis, retinal vasculitis. Right eye presented a cystoid macular edema (CME), Fluorescein angiography and optical coherence tomography (OCT) showed characteristic features of retinal vasculitis syndrome, complicated by CME in right eye. Mantoux tuberculin skin test showed an area of induration measuring 12 mm and a positive interferon-gamma release assay was documented. She started a full standard course of 4-drug antitubercular therapy, without corticosteroid therapy. CME started to resolve and showed a favourable reponse to treatment after 4 weeks. After 3 months days of treatment, BCVA improved to 20/32. After 12 months of specific treatment, BCVA was 20/20 in both eyes and CME completely resolved. After a follow-up of 18 months, BCVA was 20/20 in both eyes.
Conclusion
CME can be present initially in presumed tuberculosis uveitis. Hence it is important not to misdiagnose tuberculosis, especially before use of steroids in uveitis.
Conflict of interest
No
Author 1
Last name
MILI-BOUSSEN
Initials of first name(s)
I
Department
Department of Ophthalmology. Charles Nicolle University Hospital of Tunis
City
Tunis
Country
Tunisia
Author 2
Last name
BOUKARI
Initials of first name(s)
M
City
Tunis
Country
Tunisia
Author 3
Last name
KAOUEL
Initials of first name(s)
H
City
Tunis
Country
Tunisia
Author 4
Last name
BRAHAM-ZHIOUA
Initials of first name(s)
I
City
Tunis
Country
Tunisia
Author 5
Last name
AMMOUS
Initials of first name(s)
I
City
Tunis
Country
Tunisia
Author 6
Last name
ERRAIS
Initials of first name(s)
K
City
Tunis
Country
Tunisia
Author 7
Last name
ZHIOUA
Initials of first name(s)
R
City
Tunis
Country
Tunisia
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