Presumed Ocular tuberculosis masquerading as autoimmune retinopathy

TL;DR

A case of ocular tuberculosis was mistaken for autoimmune retinopathy, highlighting the importance of ruling out TB before using immunosuppressive treatments.

Contribution

This paper presents a rare case of ocular TB mimicking autoimmune retinopathy and emphasizes the diagnostic importance of excluding TB before immunosuppressive therapy.

Findings

A patient with TB-related retinal symptoms showed improvement after anti-tuberculosis treatment.

Steroid treatment worsened the patient's condition before TB diagnosis.

The case highlights the need to consider TB as a differential diagnosis for autoimmune retinopathy.

Abstract

To report a case of tuberculosis (TB) infection with an unusual posterior segment manifestation that mimicked autoimmune retinopathy (AIR).

A 36-year-old male presented with blurred vision and constriction of visual field (VF) in both eyes for over 2 weeks. Multimodal imaging suggested he had AIR-like retinopathy; however, the initial local/systemic steroid treatment worsened his condition. He later tested positive for TB infection and received one month of anti-tuberculosis (ATT) monotherapy, followed by combined steroid treatment for an additional 5 months. He was followed up 12 months after treatment, demonstrating significantly improved visual function and restoration of macular anatomy.

This case underscores the need to consider intraocular TB as a potential mimic of AIR, highlighting the importance of ruling out active infections before diagnosing AIR.

•Tuberculosis (TB) -related eye diseases show diverse manifestations, primarily affecting both the choroid and retina.•We presented a rare case of presumed ocular TB mimicking autoimmune retinopathy (AIR), with outer retina damage.•Rule out active TB infections before diagnosing AIR or using steroids and immunosuppressive treatments.

Tuberculosis (TB) -related eye diseases show diverse manifestations, primarily affecting both the choroid and retina.

We presented a rare case of presumed ocular TB mimicking autoimmune retinopathy (AIR), with outer retina damage.

Rule out active TB infections before diagnosing AIR or using steroids and immunosuppressive treatments.

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