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Reminder of important clinical lesson
Tubercular serpiginous-like choroiditis
  1. Marta Esteves Guedes,
  2. José Nuno Galveia,
  3. Ana Catarina Almeida,
  4. João Marques Costa
  1. Ophthalmology Department, Hospital Egas Moniz, Lisbon, Portugal
  1. Correspondence to Dr Marta Esteves Guedes, marta.ce.guedes{at}


Choroidal tuberculosis (TB) infection may present itself as a diffuse choroiditis that resembles serpiginous choroiditis, usually treated with immunossupressants. Recent studies have demonstrated that patients with serpiginous-like choroiditis and evidence of systemic or latent TB are best treated with antituberculosis treatment (ATT) in addition to the corticosteroid therapy. The authors present a case of a 58-year-old man with decreased vision in his left eye. His best-corrected visual acuity was 20/20 right eye and 20/200 left eye. Funduscopic examination revealed a diffuse choroiditis. Mantoux skin test showed an area of induration measuring 30×35 mm and the patient started ATT with complete resolution of retinal lesions after 2 weeks of treatment. His final visual acuity was 20/25 in the left eye with no recurrences over a follow-up of 6 months. The use of ATT in these patients is likely to reduce active inflammation and eliminate future recurrences.

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  • Competing interests None.

  • Patient consent Obtained.

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