Purpose

To report the clinical profile of a patient diagnosed with posterior scleritis secondary to latent tuberculous infection in Ospital ng Maynila Medical Center

Methods

A retrospective review of the medical records of the patient diagnosed with posterior scleritis secondary to latent tuberculous infection in Ospital ng Maynila Medical Center

Results

A 25 year old male consulted due to one month history of sudden blurring of central vision of the right eye described as distorted images almost encompassing half of his right visual field, associated with right eye pain and headache. Vision for right eye was CF at 1 ft, 20/20 for left. External eye exam and slit lamp exam were unremarkable. Fundoscopy of the right eye showed multiple subretinal hyperpigmented lesions at the superior temporal area and macula. FA was done revealing good dye transit, window defect at the superior and inferior temporal area the macula corresponding to the hyperpigmented lesions on color fundoscopy. Macular OCT of the revealed a dome shaped elevation of the entire macula above the 99th percentile. Patient then turned out positive in PPD and Quantiferon Gold. Patient was started on Prednisolone 1mg/kg and initiated on TB treatment. Six weeks after, VA for both eyes were 20/20. Fundoscopy macular OCT post-treatment showed decrease in the amount of subretinal hyperpigmented lesions and resolution of dome shaped elevation.

Conclusions

This case report illustrates how diverse the manifestation of tuberculosis can be even when it is latent. It is very important to carefully consider all the signs and symptoms of patients and supplement them with the given laboratory and imaging available in order to provide the best management for the patient.