Kaza Hrishikesh, Gala Jignesh Manshibhai, Rani Padmaja Kumari
Uveitis Service, L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India.
Smt Kannuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India.
BMJ Case Rep. 2021 May 24;14(5):e240280. doi: 10.1136/bcr-2020-240280.
Multifocal choroiditis (MFC) can be associated with ocular tuberculosis (TB). Inflammatory peripapillary choroidal neovascular membrane (PPCNVM) is uncommon in TB MFC. Subretinal pigment epithelial inflammatory lesions are suggestive of acute inflammation or reactivation of inflammation in the setting of MFC. We present a case of MFC, of tubercular aetiology, during course of treatment of PPCNVM developed a subfoveal retinal pigment epithelial lesion. Clinical examination suggested a recurrence of PPCNVM, with the new macular lesions posing a dilemma of new onset inflammatory choroidal neovascular membrane (CNVM) at the macula versus reactivation of choroiditis at the posterior pole. Multimodal imaging helped differentiate the lesion from CNVM and give the appropriate antitubercular treatment to prevent future recurrences.
多灶性脉络膜炎（MFC）可与眼结核（TB）相关。炎性视乳头周围脉络膜新生血管膜（PPCNVM）在结核性MFC中并不常见。视网膜色素上皮下炎性病变提示MFC情况下的急性炎症或炎症再激活。我们报告一例病因结核的MFC病例，在PPCNVM治疗过程中出现了黄斑下视网膜色素上皮病变。临床检查提示PPCNVM复发，新的黄斑病变带来了黄斑区新发炎性脉络膜新生血管膜（CNVM）与后极部脉络膜炎再激活的两难局面。多模态成像有助于将该病变与CNVM区分开来，并给予适当的抗结核治疗以预防未来复发。
