Coexistent miliary tuberculosis of choroid and tubercular panuveitis: A report
A 27-year-old man presented with progressively worsening vision in his left eye for 1 month. He was a known case of tubercular meningitis on four drugs antitubercular medication (ATT). He had 6/6 vision in the right eye with an unremarkable anterior segment. Left eye had perception of light. Fig. and depict slit lamp evaluation of active panuveitis in the left eye. An ultrasound examination followed by [] was performed due to poor view of the fundus, which revealed vitritis, thickened retinochoroidal complex and attached retina consistent with panuveitis. shows choroidal miliary tubercles in the right eye. Fundus fluorescein angiography revealed active choroiditis lesions []. Polymerase chain reaction (PCR) performed on the aqueous aspirate from the left eye revealed MPB64 gene and nested-PCR (nPCR) detected IS6110 region specific for Mycobacterium tuberculosis (MTB) []. High resolution computerized tomography of the chest revealed tubercular miliary mottling in both lungs.\nPatient was advised to continue ATT and lensectomy with vitrectomy was performed in the left eye. Extensive choroidal tubercles were noted during surgery. Figs. and show progressive resolution of the choroiditis lesions at 1 and 2 months follow-up respectively in the right eye with vision maintained at 6/6. Left eye had best-corrected visual acuity of counting fingers with a hazy media, dense epiretinal membrane, scarring at fovea and attached retina [] at 2 months. Fig. and reveal anterior segment findings in the left eye at 1 and 2 months respectively.