2.Bilateral Retinal Vasculitis: A Presumed Case of Ocular TB without Inflammation
Umi Kalthum MN ; Norfarizal A ; Rona Asnida N ; Ayesha MZ ; Jemaima CH
Medicine and Health 2012;7(2):97-101
A 17-year-old male student of Indonesian parentage presented with two weeks history of progressive painless bilateral visual deterioration. There was no contact
with tuberculosis (TB)-infected patients and parents claimed that all immunization
including BCG was completed. However, BCG scar was not apparent. Visual
acuity was 6/36 and 6/60 in the right and left eyes respectively. The anterior and
vitreous chambers were quiet. Funduscopic examination revealed retinal vasculitis
with perivascular exudates, branch vein occlusion, neovascularization and macular
oedema. Fluorescein angiography confirmed large areas of capillary non-perfusion
and leaking new vessels. Mantoux test was positive and full regime anti-TB therapy
was instituted. HIV screening was negative. Three days later, an immunosuppressive dose of oral steroid was started. Both eyes received intensive laser photocoagulation.
Interestingly, there was no development of vitritis throughout.