tuberculosis revealed by occlusive retinal venous vasculitis: a case report

Author: sara el hachimi (Morocco)

Co-authors: fatima zahrae bahari, adil mchachi, leila benhmidoune, abderrahim chakib, rayad rachid, mohamed el belhadji

Purpose

The aim of this work is to provide an update on this poorly known and sometimes under-diagnosed pathology due to its rarity.

Setting/Venue

adult ophthalmology department, hospital 20 aout, casablanca, morocco

Methods

IShe is a 40 years old woman, immunocompetent, well vaccinated, without any particular history, Consulted urgently for a decrease in visual acuity for distance and near rapidly progressive in a few days, at the examination: a collapsed visual acuity in bilateral, the anterior segment is without particularities, at the bottom of the eye we objective a pre-retinal hemorrhage of the right eye and intravitreal hemorrhage of the left eye.

Results

At the retinal angiography, a retinal vasculitis with a fibro-vascular veil was observed in the right eye and a vaso-occlusive vasculitis was observed in the left eye, at the etiological check-up, a positive IDR with tuberculin was observed, the quantiferon dosage was normal: The thoracic-abdominopelvic scan was normal (no parenchymal lesions or adenopathy), an etiological search ruled out Behçet's disease, sarcoidosis, syphilis and borreliosis, which allowed us to retain the diagnosis of tuberculous occlusive periphlebitis without systemic infection.

Conlusions

Ocular tuberculosis remains a rare entity in immunocompetent patients, but it should be evoked in the presence of an isolated inflammation of the ocular tissues. The diagnosis is most often based on a combination of clinical, biological and radiological evidence.

Financial Disclosure

Ophtalmology departement of August 20 hospital 1935 of casablanca