Subretinal fluid analysis in the diagnosis of choroidal tuberculosis.

Background: Diagnosis of intraocular tuberculosis is often difficult. A choroidal granulomalike lesion suspected to be the result of tuberculosis could be of other inflammatory, infective, or neoplastic causes. We report two cases in which a choroidal granuloma with exudative retinal detachment was diagnosed as tuberculosis by the detection of acid-fast bacilli in subretinal fluid.

Methods: Interventional case series.

Results: Two female patients had choroidal granulomas with surrounding exudative retinal detachment. Detailed laboratory investigations were unhelpful in diagnosis, and the patients' conditions worsened with systemic steroid therapy. Subretinal fluid was tapped and revealed acid-fast bacilli and grew Mycobacterium tuberculosis on culture.

Conclusion: Subretinal fluid analysis can help in the detection of tuberculous granuloma and facilitate successful management.