Management of Tubercular Retinal Vasculitis: A Case Report From an Endemic Region

TL;DR

This case report describes the successful treatment of a man with tubercular retinal vasculitis in India, emphasizing early diagnosis and management.

Contribution

The paper presents a detailed case of tubercular retinal vasculitis management in an endemic region, highlighting diagnostic and therapeutic approaches.

Findings

The patient showed typical fundus findings like perivascular infiltrates and cystoid macular edema.

Treatment with anti-tubercular therapy, triamcinolone injections, and laser photocoagulation led to significant improvement.

The patient maintained good visual acuity and no complications over two years of follow-up.

Abstract

India, being an endemic country for tuberculosis, has a very high prevalence of pulmonary and extrapulmonary tuberculosis. Various manifestations of ocular tuberculosis have been described, including granulomatous anterior uveitis, serpiginous choroiditis, and retinal vasculitis. We hereby describe the case of a 39-year-old male patient who presented to our clinic with complaints of diminished vision in the right eye for five months. His best-corrected visual acuity was 6/12 in the right eye with normal anterior segment examination. He was misdiagnosed as having central serous chorioretinopathy in the right eye at a primary center. The patient had typical fundus findings of perivascular infiltrates, focal vascular tortuosity, vitreous snowball infiltrates, and cystoid macular edema. Fluorescein angiography was done to evaluate the retinal findings and capillary non-perfusion areas. The patient was referred to a physician for the initiation of anti-tubercular treatment. Posterior sub-Tenon injection of triamcinolone acetonide was given for cystoid macular edema, and laser photocoagulation of capillary non-perfusion areas of the retina was done. The patient responded well to treatment with resolution of macular edema and healing of perivascular infiltrates. His visual acuity improved to 6/6 at the three-month follow-up. The patient was followed up for a period of two years with no reported complications or recurrences. This case highlights the diagnostic features of tubercular retinal vasculitis and its management.

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