Título / Title

CHRONIC CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED TO LATENT TUBERCULOSIS

Introdução / Purpose

Chronic Central Serous Chorioretinopathy (CCSC) is characterized by persistent, recurrent or multifocal macular epithelium pigment detachment (PED) and/or neurosensory retinal detachment (NRD).

Material e Método / Methods

Case report of atypical CSCC presentation associated with Latent Tuberculosis.

Resultados / Results

A 44-year-old male, complaining of low vision for 2 years, reports CSCC diagnosis and previous treatment with spironolactone and anti-angiogenic without any clinical improvement. He had no records of systemic diseases. Visual acuity of count fingers, in the right eye, and 20/100 in the left eye. Anterior segment was normal. Fundus examination revealed PED, areas of lipid exudation and diffuse chorioretinal atrophy in posterior pole in both eyes. Fluorescein Angiography with multiple areas of pooling. Indocyanine Green Angiography shows increased of vascular permeability. Optical Coherence Tomography (OCT) demonstrates serous PED in both eyes. Serum tests with inflammatory and rheumatological factors were normal. Infective screening with Tuberculin Test showed strong reactor. There was no clinical or radiological evidence of pulmonary tuberculosis. CSCC secondary to Latent Tuberculosis was then suggested and treatment regime of tuberculosis was initiated. The patient returned after 2 months with improved of vision to 20/70 and 20/60.

Discussão e Conclusões / Conclusion

Two cases of latent tuberculosis have been reported as a possible cause of CSCC refractory to standard treatment. Khan et al. described CSCC case with multiple recurrences, in which diagnosis of latent tuberculosis was taken into account after re-evaluation of family history and infectious screening, in this case there were no recurrences of CSCC after appropriate tuberculosis treatment. The present report reiterates the importance of searching possible clinical causes of CSCC through a detailed clinical history, infectious and inflammatory screenings.

Palavras Chave

Central Serous Chorioretinopathy, Tuberculosis