Nested PCR-positive Tubercular Ampiginous Choroiditis: A Case Report

Abstract

Objective: To report on ampiginous choroiditis of tubercular etiology with nPCR positivity for M. tb in aqueous sample and also to stress upon the usefulness of nPCR to consolidate the etiological diagnosis.

Material and methods: Case report of a patient presenting with active ampiginous choroiditis with no evidence of systemic TB but had hilar and para-tracheal lymphadenopathy on CT chest. QuantiFERON TB gold test was positive The patient responded inadequately to systemic anti-tubercular treatment and oral steroids. Nested PCR for M.tb was done on aqueous sample was positive for MPB64 gene of M.tb. Anti-TB treatment was continued inspite of initial poor response to which the patient responded and his choroiditis regressed.

Results: Ocular tuberculosis forms the essential differential diagnosis of any chronic or recurrent choroiditis, especially in high endemic areas. The presumed tubercular etiology can be substantiated using highly sensitive and specific tests such as nested PCR on intraocular fluid.

KEYWORDS::

• Ampiginous choroiditis
• serpiginous choroiditis
• acute posterior multifocal
• placoid pigment epithelopathy
• mycobacterium tuberculosis
• nested polymerase chain reaction

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