Subretinal Hypopyon in Presumed Tubercular Uveitis: A Report of Two Cases

Subretinal hypopyon is an uncommon entity which has been described in ocular infections and inflammations including endophthalmitis, acute retinal necrosis, and sympathetic ophthalmia. The authors report subretinal hypopyon in two cases of presumed tubercular uveitis which responded well to antitubercular therapy (ATT). The first case was a 47-year-old male with bilateral peripapillary chorioretinitis with a subretinal hypopyon. Tuberculosis was confirmed on biopsy of a cervical lymph node which revealed acid-fast bacilli. Case 2 was a 17-year-old male with unilateral involvement in the form of a choroidal granuloma with disc edema and retinitis. In addition, a subretinal hypopyon was evident. Both these cases showed dramatic anatomical improvement with ATT. A novel finding of subretinal hypopyon is described in these cases of presumed ocular tuberculosis. It may be prudent to start empirical ATT early on detection of a subretinal hypopyon along with other manifestations compatible with tubercular etiology.