Tuberculosis Retinitis

Introduction

Caused by mycobacterium tuberculosis, leading to chronic progressive granulomatous infection commonly via hematogenous spread.
- Primarily affects the lungs, but also cardiovascular system, GIT, musculoskeletal system, genitourinary tract, CNS, skin and eyes
- Choroidal tubercles are the most common form of ocular tuberculosis, typically small and multiple

Dead Giveaways

Tubercules in choroid:

Often associated with exudative retinal detachment
Acute rapidly spreading inflammation with necrosis and possible ruptured globe.
The white dots seen represent the choroidal tubercles
Arej N. et al. 2016. Shows the OCT through the tubercle, with the location of the tubercle and associated exudative RD

diagnostic features

Signs:

Anteriorly image shows mutton fat KP and distorted pupils
Occlusive vascular events like CWS and venous sheathing
Haemorrhages and conclusive neovascularisation
Can cause panophthalmitis