Tuberculous Uveitis Presenting with a Bullous Exudative Retinal Detachment: A Case Report and Systematic Literature Review

ABSTRACT

Purpose: To describe tuberculous uveitis (TU) presenting as a bullous retinal detachment (RD) and to perform a comprehensive literature review on TU with similar features.

Methods: Observational case report and systematic literature review.

Results: An 84-year-old woman presented with bilateral granulomatous uveitis and bullous RD in the left eye. The interferon gamma release assay was strongly positive, but all other tests were unremarkable. The patient was diagnosed with TU and started on anti-tubercular therapy (ATT) and systemic steroids with excellent treatment response. Twenty-six articles (32 cases) reported TU with exudative RD. Choroidal tuberculoma was the most common clinical manifestation, followed by optic disc edema and retinal exudate. Systemic steroids with ATT improved vision in more patients (78.6%) than ATT alone (50.0%) or oral steroids followed by ATT (50.0%).

Conclusion: Atypical presentations of TU make diagnosis and treatment difficult. A high level of suspicion for TU is needed to minimize ocular morbidity.

Keywords:

• Anti-tubercular therapy
• choroiditis
• mycobacterium tuberculosis
• ocular tuberculosis
• retinal detachment
• tuberculosis
• uveitis

Acknowledgments

We gratefully acknowledge Ms Yu Young Heo at Ajou University Medical Information & Media Center for technical and clerical support in the database search process.

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Declaration of Interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

DAG is supported by an unrestricted grant from Research to Prevent Blindness (NY).