Vol 5 (2020): Continuous Publishing
Case report
Published online: 2020-12-28

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Multifocal serpiginous-like choroiditis revealing mediastinal lymph node tuberculosis

Imane Chabbar1, Louai Serghini1, Zakia Hajji1, Abdelkrim Boulanouar1, Amina Berraho1
Ophthalmol J 2020;5:146-149.

Abstract

Serpiginous-like choroiditis is a rare manifestation of intraocular tuberculosis. It most often occurs in the context of suspected or latent tuberculosis. The diagnostic confirmation remains a real challenge. We report a case of a young patient presented with rapid bilateral visual acuity decrease. The diagnosis of tuberculous serpiginous-like choroiditis associated with mediastinal lymph node tuberculosis was established based on anamnestic, clinical, radiographic, and histological arguments. Anti-tuberculosis drugs have been recommended in combination with corticotherapy. The evolution was marked by significant stabilization of choroidal lesions with an improvement in visual acuity. Given its great clinical polymorphism, ocular tuberculosis should be suspected in any ocular inflammation, even atypical, in order to start early and appropriate treatment and improve the visual prognosis.

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References

  1. Forrellad M, Klepp L, Gioffré A, et al. Virulence factors of the Mycobacterium tuberculosis complex. Virulence. 2013; 4: 3–66.
  2. Martinson NA, Hoffmann CJ, Chaisson RE, et al. Epidemiology of tuberculosis and HIV: recent advances in understanding and responses. Proc Am Thorac Soc. 2011; 8(3): 288–293.
  3. Shakarchi FI, Shakarchi FI, Shakarchi FI. Ocular tuberculosis: current perspectives. Clin Ophthalmol. 2015; 9: 2223–2227.
  4. Willermain F, Makhoul D, Caspers L, et al. Uvéites tuberculeuses. Les Uvéites. 2010: 121–128.
  5. Nazari Khanamiri H, Rao NA, Nazari Khanamiri H, et al. Serpiginous choroiditis and infectious multifocal serpiginoid choroiditis. Surv Ophthalmol. 2013; 58(3): 203–232.
  6. Lim WK, Buggage RR, Nussenblatt RB, et al. Serpiginous choroiditis. Surv Ophthalmol. 2005; 50(3): 231–244.
  7. Rao NA, Saraswathy S, Smith RE, et al. Tuberculous uveitis: distribution of Mycobacterium tuberculosis in the retinal pigment epithelium. Arch Ophthalmol. 2006; 124(12): 1777–1779.
  8. Bouchenaki N, Cimino L, Auer C, et al. Assessment and classification of choroidal vasculitis in posterior uveitis using indocyanine green angiography. Klin Monbl Augenheilkd. 2002; 219(4): 243–249.
  9. Laatikainen L, Erkkilä H, Erkkilä H, et al. Serpiginous choroiditis. Br J Ophthalmol. 1974; 58(9): 777–783.
  10. Gupta V, Gupta A, Arora S, et al. Presumed tubercular serpiginouslike choroiditis: clinical presentations and management. Ophthalmology. 2003; 110(9): 1744–1749.
  11. Mackensen F, Becker MD, Wiehler U, et al. QuantiFERON TB-Gold--a new test strengthening long-suspected tuberculous involvement in serpiginous-like choroiditis. Am J Ophthalmol. 2008; 146(5): 761–766.
  12. Gan WL, Jones NP, Gan WL, et al. Serpiginous-like choroiditis as a marker for tuberculosis in a non-endemic area. Br J Ophthalmol. 2013; 97(5): 644–647.