32-year-old male with diagnosis of central serous chorioretinopathy (CSCR) in both eyes and negative history of administration of any medicine was treated with bilateral focal laser at leakage point, with visual recovery. Recurrence occurred after 2 years in right eye and was treated successfully with acetazolamide. Second recurrence occurred after 1 year. Acetazolamide was restarted, but no improvement was noted. Thorough re-evaluation of the patient revealed a family history of tuberculosis. Ancillary investigations rendered the presumptive diagnosis of tuberculosis, and antituberculosis treatment led to visual recovery with no recurrences. Present case poses two dilemmas: whether CSCR was secondary to tuberculosis or was it an incidental association in tuberculosis endemic population and second whether resolution occurred due to the treatment of tuberculosis or due to mineralo-corticoid antagonism action of rifampicin. Significance of patient's history, clinical observation and angiographic studies in the diagnosis of idiopathic and recurrent CSCR is reiterated.
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| http://dx.doi.org/10.1136/bcr-2016-216471 | DOI Listing |
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