Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis
Abstract Aim To report a case of intraocular tuberculosis presenting as acute macular neuroretinopathy and central retinal vein occlusion. Case description A 29-year-old man presented to the retina clinic with complaints of sudden blurring of vision in the left eye of 3 days duration. His visual acu...
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doaj-c23e4f6363f84058a8887501293f10492020-11-25T01:27:38ZengSpringerOpenJournal of Ophthalmic Inflammation and Infection1869-57602020-02-011011510.1186/s12348-020-00201-7Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosisRamesh Venkatesh0Sajjan Sangai1Arpitha Pereira2Padmamalini Mahendradas3Naresh Kumar Yadav4Department of Retina, Vitreous and Ocular Inflammation, Narayana NethralayaDepartment of Retina, Vitreous and Ocular Inflammation, Narayana NethralayaDepartment of Retina, Vitreous and Ocular Inflammation, Narayana NethralayaDepartment of Retina, Vitreous and Ocular Inflammation, Narayana NethralayaDepartment of Retina, Vitreous and Ocular Inflammation, Narayana NethralayaAbstract Aim To report a case of intraocular tuberculosis presenting as acute macular neuroretinopathy and central retinal vein occlusion. Case description A 29-year-old man presented to the retina clinic with complaints of sudden blurring of vision in the left eye of 3 days duration. His visual acuity was 6/6 and 6/18 in the right and left eye, respectively. Fundus examination of the left eye showed features of central retinal vein occlusion. OCT showed features of type 2 acute macular neuroretinopathy (AMN) as well. Over a period of 2 weeks, the patient developed choroidal granulomas with overlying retinal elevation and peripapillary choroidal neovascular membrane and retinal granuloma. Mantoux test and HRCT chest confirmed the diagnosis of pulmonary tuberculosis. Results The patient was treated with a course of antitubercular therapy, oral corticosteroids and a single dose of intravitreal anti-vascular endothelial growth factor (1.25 mg/0.05 ml Bevacizumab, Roche Pharma) injection. After 6 months of therapy with ATT and tapering course of oral steroids, there was a complete resolution of all clinical signs including the choroidal granuloma with an improvement in visual acuity to 6/6. Conclusion Acute macular neuroretinopathy can complicate intraocular TB. Tuberculosis should be kept as one of the differential diagnosis in patients with AMN. Prognosis is generally good in patients of ocular TB presenting with retinal vascular occlusions.http://link.springer.com/article/10.1186/s12348-020-00201-7Intraocular tuberculosisAcute macular neuroretinopathyCentral retinal vein occlusion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ramesh Venkatesh Sajjan Sangai Arpitha Pereira Padmamalini Mahendradas Naresh Kumar Yadav |
spellingShingle |
Ramesh Venkatesh Sajjan Sangai Arpitha Pereira Padmamalini Mahendradas Naresh Kumar Yadav Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis Journal of Ophthalmic Inflammation and Infection Intraocular tuberculosis Acute macular neuroretinopathy Central retinal vein occlusion |
author_facet |
Ramesh Venkatesh Sajjan Sangai Arpitha Pereira Padmamalini Mahendradas Naresh Kumar Yadav |
author_sort |
Ramesh Venkatesh |
title |
Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
title_short |
Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
title_full |
Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
title_fullStr |
Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
title_full_unstemmed |
Acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
title_sort |
acute macular neuroretinopathy with coexistent central retinal vein occlusion as the presenting feature in intraocular tuberculosis |
publisher |
SpringerOpen |
series |
Journal of Ophthalmic Inflammation and Infection |
issn |
1869-5760 |
publishDate |
2020-02-01 |
description |
Abstract Aim To report a case of intraocular tuberculosis presenting as acute macular neuroretinopathy and central retinal vein occlusion. Case description A 29-year-old man presented to the retina clinic with complaints of sudden blurring of vision in the left eye of 3 days duration. His visual acuity was 6/6 and 6/18 in the right and left eye, respectively. Fundus examination of the left eye showed features of central retinal vein occlusion. OCT showed features of type 2 acute macular neuroretinopathy (AMN) as well. Over a period of 2 weeks, the patient developed choroidal granulomas with overlying retinal elevation and peripapillary choroidal neovascular membrane and retinal granuloma. Mantoux test and HRCT chest confirmed the diagnosis of pulmonary tuberculosis. Results The patient was treated with a course of antitubercular therapy, oral corticosteroids and a single dose of intravitreal anti-vascular endothelial growth factor (1.25 mg/0.05 ml Bevacizumab, Roche Pharma) injection. After 6 months of therapy with ATT and tapering course of oral steroids, there was a complete resolution of all clinical signs including the choroidal granuloma with an improvement in visual acuity to 6/6. Conclusion Acute macular neuroretinopathy can complicate intraocular TB. Tuberculosis should be kept as one of the differential diagnosis in patients with AMN. Prognosis is generally good in patients of ocular TB presenting with retinal vascular occlusions. |
topic |
Intraocular tuberculosis Acute macular neuroretinopathy Central retinal vein occlusion |
url |
http://link.springer.com/article/10.1186/s12348-020-00201-7 |
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