Amjad Muhammad, Zafar Aruba
Vitreoretina, Al Shifa Trust Eye Hospital, Rawalpindi, PAK.
Ophthalmology, Al Shifa Trust Eye Hospital, Rawalpindi, PAK.
Cureus. 2024 Jul 9;16(7):e64200. doi: 10.7759/cureus.64200. eCollection 2024 Jul.
A middle-aged hypertensive female presented with headaches, tinnitus, and blurred vision for two weeks. Clinical examination revealed mild vitritis and bilateral multifocal exudative detachments at the posterior pole, together with peripheral vascular cuffing and peri-phlebitis. Laboratory testing pointed towards isolated presumed intraocular tuberculosis (IOTB) as the probable cause. However, the patient strongly responded to high-dose intravenous and tapered oral corticosteroids, leading to complete resolution of detachments within 10 days of therapy initiation. Anti-tubercular therapy (ATT) was begun after one week of presentation, and no recurrence of symptoms was noted for the next 18 months. A case of Vogt-Koyanagi-Harada (VKH) disease-like presentation occurred after a probable previous subclinical episode(s) of presumed IOTB, resulting in sclerosed vessels in the retinal periphery.
一名中年高血压女性出现头痛、耳鸣和视力模糊两周。临床检查发现轻度玻璃体炎和后极部双侧多灶性渗出性视网膜脱离，伴有周边血管套袖样改变和静脉周围炎。实验室检查提示孤立性疑似眼内结核（IOTB）可能是病因。然而，患者对大剂量静脉注射及逐渐减量的口服糖皮质激素反应强烈，治疗开始后10天内视网膜脱离完全消退。就诊一周后开始抗结核治疗（ATT），接下来的18个月未再出现症状。在可能之前存在的疑似IOTB亚临床发作后，出现了类似伏格特 - 小柳 - 原田（VKH）病的表现，导致视网膜周边血管硬化。
