Successful treatment of tubercular multifocal serpiginous-like choroiditis without use of anti-inflammatory drugs: A case report with multimodal imaging

PURPOSE: To report the successful management of a case of tuberculosis (TB) related multifocal serpiginous-like choroiditis with anti-TB medications alone. METHODS: A case report with multimodal imaging. RESULTS: A 28-year-old man presented with progressive loss of vision in his left eye. He mentioned a similar history for his right eye about 2 years earlier. Fundus examination showed multiple discrete greyish irregularly bordered lesions in both eyes. Based on a highly positive skin tuberculin test and exclusion of other possible causes, a diagnosis of presumed TB associated multifocal serpiginous-like choroiditis was made, and quadruple classic anti-TB therapy was initiated. One year after introduction of anti-TB treatment, active lesions turned into scars, with significant improvement of vision. CONCLUSION: Anti-TB therapy may be enough as the only necessary treatment for TB-related serpiginous-like choroiditis.