Subfoveal retinal pigment epithelium inflammatory lesion presenting as a sign of reactivation of tubercular multifocal choroiditis

Multifocal choroiditis (MFC) can be associated with ocular tuberculosis (TB). Inflammatory peripapillary choroidal neovascular membrane (PPCNVM) is uncommon in TB MFC. Subretinal pigment epithelial inflammatory lesions are suggestive of acute inflammation or reactivation of inflammation in the setti...

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Bibliographic Details
Published in:BMJ case reports 2021-05, Vol.14 (5), p.e240280
Main Authors: Kaza, Hrishikesh, Gala, Jignesh Manshibhai, Rani, Padmaja Kumari
Format: Article
Language:English
Subjects:
Case Report
Case reports
Choroiditis - diagnosis
Data collection
Edema
Fluorescein Angiography
Humans
Medical imaging
Multifocal Choroiditis
Retinal Pigment Epithelium
Retrospective Studies
Tuberculosis
Tuberculosis, Ocular - diagnosis
Tuberculosis, Ocular - drug therapy
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Summary:Multifocal choroiditis (MFC) can be associated with ocular tuberculosis (TB). Inflammatory peripapillary choroidal neovascular membrane (PPCNVM) is uncommon in TB MFC. Subretinal pigment epithelial inflammatory lesions are suggestive of acute inflammation or reactivation of inflammation in the setting of MFC. We present a case of MFC, of tubercular aetiology, during course of treatment of PPCNVM developed a subfoveal retinal pigment epithelial lesion. Clinical examination suggested a recurrence of PPCNVM, with the new macular lesions posing a dilemma of new onset inflammatory choroidal neovascular membrane (CNVM) at the macula versus reactivation of choroiditis at the posterior pole. Multimodal imaging helped differentiate the lesion from CNVM and give the appropriate antitubercular treatment to prevent future recurrences.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-240280