Cargando…

Nodular posterior scleritis associated with presumed ocular tuberculosis: A multimodal imaging case report

PURPOSE: To describe a patient with nodular posterior scleritis associated with presumed ocular tuberculosis (TB). OBSERVATIONS: A 25-year-old Caucasian man reported metamorphopsia in the right eye (OD). He had lost the vision in his left eye when he was 15 years old. The visual acuity (VA) levels w...

Descripción completa

Detalles Bibliográficos
Autores principales: Moreira-Neto, Carlos, Moreira Jr., Carlos, Tolentino, Diego, Duker, Jay S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804507/
https://www.ncbi.nlm.nih.gov/pubmed/31650086
http://dx.doi.org/10.1016/j.ajoc.2019.100558
Descripción
Sumario:PURPOSE: To describe a patient with nodular posterior scleritis associated with presumed ocular tuberculosis (TB). OBSERVATIONS: A 25-year-old Caucasian man reported metamorphopsia in the right eye (OD). He had lost the vision in his left eye when he was 15 years old. The visual acuity (VA) levels were 20/20 and light perception in the right and left eyes, respectively. Wide-field color fundus photography, fluorescein and indocyanine green angiography, optical coherence tomography, and ultrasound suggested an inflammatory condition associated with an elevated lesion in the choroid/sclera. The purified protein derivative (PPD) skin test and all other screening tests were negative. A diagnosis of presumed nodular posterior scleritis was made and after oral corticosteroid therapy, the VA decreased to 20/100 OD associated with a red and painful eye. Subsequently a QuantiFERON-TB test was positive, tuberculosis (TB) treatment was started and the corticosteroid dose was increased. Three months after treatment, the pain resolved and the vision OD recovered to 20/20. CONCLUSIONS AND IMPORTANCE: Nodular posterior scleritis can be associated with ocular TB that did not have a pulmonary manifestation. Rigorous testing is required in order to prevent visual loss in this disease that is not easily diagnosed.