Tubercular subretinal abscess in a pediatric intermediate uveitis patient on methotrexate

• Main Authors: Nivedita Nair, S Sudharshan, M Ram Prakash, Vikas Khetan, Chetan Rao
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: idiopathic intermediate uveitis (iu); methotrexate; subretinal abscess; tuberculosis (tb); juvenile idiopathic arthritis
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2020;volume=68;issue=9;spage=2043;epage=2045;aulast=

Pediatric intermediate uveitis (IU), usually idiopathic, can also be associated with tuberculosis (TB) and sarcoidosis. A 14-year-old girl was diagnosed with idiopathic IU after ruling out TB and sarcoid. She was treated with oral steroids and methotrexate (MTX) with good inflammation control. One year later, she presented with subretinal (SR) abscess. Lab tests were still negative but aqueous polymerase chain reaction confirmed TB. With antituberculosis treatment, complete resolution of the lesion was noted. The likelihood of a change in phenotype of ocular TB, from an IU to TB SR abscess or a possible reactivation of latent TB due to MTX are discussed.