A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on...A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on eye movement.She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago.She was started on anti-TB since then but defaulted highly active anti-retroviral therapy(HAART).On examination.her visual acuity was no perception of light in the right eye and 6/120(pinhole 3/60) in the lelt eye.Anterior segment in both eyes was unremarkable.Funduscopy showed bilateral optic disc swelling with presence ot multiple foci of choroiditis in the peripheral retina.The vitreous and relinal vessels were normal.Chest radiography was normal.CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis.This patient was managed with infectious disease team.She was started on HAART and anti-TB treatment was continued.She completed anti-TB treatment alter 9 months without any serious side effects.During follow up the visual acuity in both eyes was not improved.However.funduscopy showed resolving ol disc swelling and choroiditis following treatment.展开更多
文摘A 27 year-old lady,presented with sudden loss of vision in the right eve tor a week.It was followed In poor vision in the left eye alter 3 days.It involved the whole entire visual field and was associated with pain on eye movement.She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago.She was started on anti-TB since then but defaulted highly active anti-retroviral therapy(HAART).On examination.her visual acuity was no perception of light in the right eye and 6/120(pinhole 3/60) in the lelt eye.Anterior segment in both eyes was unremarkable.Funduscopy showed bilateral optic disc swelling with presence ot multiple foci of choroiditis in the peripheral retina.The vitreous and relinal vessels were normal.Chest radiography was normal.CT scan of orbit and brain revealed bilateral enhancement of the optic nerve sheath that suggest the diagnosis of bilateral atypical optic neuritis.This patient was managed with infectious disease team.She was started on HAART and anti-TB treatment was continued.She completed anti-TB treatment alter 9 months without any serious side effects.During follow up the visual acuity in both eyes was not improved.However.funduscopy showed resolving ol disc swelling and choroiditis following treatment.
