Ocular Tuberculosis with Sea Fan Neovascularization: A Case Report and Literature Review

Abstract

Eye diseases may lead to visual impairment which is one of the public's most feared disabilities. Tuberculosis is a systemic infectious disease caused by Mycobacterium tuberculosis. Ocular tuberculosis is a rare manifestation of this condition. We report the case of a 36-year-old patient who was referred to the ophthalmology department due to acute vision loss in both eyes. An ophthalmological examination revealed retinal vasculitis in both eyes, complicated by pre-retinal neovascularization. Blood tests were positive for QuantiFERON-TB Gold, and the Mantoux test was also positive. Antitubercular treatment was initiated, along with corticosteroids, leading to a positive evolution within two months. Recovery under antitubercular treatment is observed in 95% of cases of presumed ocular tuberculosis; however, there is currently no consensus on the optimal duration of treatment. Diagnosing ocular tuberculosis remains challenging. Although retinal vasculitis is rare in ocular tuberculosis, it is associated with a poor prognosis, and the visual outcome heavily depends on the timely initiation of appropriate treatment, which can stabilize or improve vision.