Rapidly Progressing Foveal Atrophy with Tuberculous Serpiginous-Like Choroiditis Despite Combined Anti-Tuberculosis and Steroid Treatment.
10.3341/jkos.2013.54.8.1287
- Author:
Jin Young LEE
1
;
Kun Wook KANG
;
Jae Pil SHIN
;
In Taek KIM
;
Dong Ho PARK
Author Information
1. Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea. sarasate2222@gmail.com
- Publication Type:Case Report
- Keywords:
Anti-tuberculous therapy;
Foveal atrophy;
Indocyanine green angiography;
Interferon-gamma release assay;
Tuberculous serpiginous-like choroiditis
- MeSH:
Angiography;
Atrophy;
Blood Sedimentation;
Choroid;
Choroiditis;
Edema;
Female;
Fingers;
Fluorescein Angiography;
Hand;
Humans;
Indocyanine Green;
Interferon-gamma Release Tests;
Magnetic Resonance Imaging;
Prognosis;
Serologic Tests;
Subretinal Fluid;
Tomography, Optical Coherence;
Vision, Ocular;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2013;54(8):1287-1292
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of rapidly progressing foveal atrophy with tuberculous serpiginous-like choroiditis. CASE SUMMARY: A 54-year-old female patient had decreased vision of hand motions (os) for 3 days. Fundus examination showed optic disc swelling and yellowish chorioretinal lesions in the posterior pole (os). Optical coherence tomography (OCT) showed intraretinal edema and subretinal fluid in the left macula. Routine laboratory tests, serologic tests, and magnetic resonance imaging results were normal except for erythrocyte sedimentation rate (28 mm/hr). Fluorescein angiography showed the chorioretinal lesions appeared to be early hypofluorescence followed by late hyperfluorescence. Indocyanine green angiography showed hypofluorescence during early and late phases and the result of interferon-gamma release assay was positive. Under diagnosis of tuberculous serpiginous-like choroiditis, anti-tuberculous therapy combined with systemic corticosteroid was started. Despite decreased optic disc swelling, OCT showed a rapid progression of foveal atrophy within 2 weeks. Twelve weeks later, visual acuity was finger count at 10 cm. Six months later, best-corrected visual acuity and foveal atrophy were no interval change. CONCLUSIONS: Tuberculous serpiginous-like choroiditis with foveal involvement can show rapidly progressive foveal atrophy and poor visual prognosis.
