First Author: A.Ramezani IRAN
Co Author(s): H. Mughaddasifar H. Nikkhah B. Nasri Razin 0 0 0 0 0 0 0 0 0
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To report a case presented as papillophlebitis with positive Mantoux test that respond clinically to anti-tuberculosis medications.
Ophthalmology department of a university hospital. Ophthalmic Research Center of Shahid Beheshti University of Medical Sciences and Imam Hossein Medical Center.
In this case report, a 35-year-old lady who had a history of decreased vision in her right eye for one week, is presented. She did not report any significant systemic disease. Corrected visual acuity was 20/80 and 20/20 in her right and left eyes, respectively. Right relative afferent pupillary defect was present slightly. There was a mild anterior vitritis in the right eye. Right eye fundoscopy showed retinal hemorrhages, cotton wool spots, and venous engorgement and dilation in all quadrants as well as swollen optic disc. Clinical diagnosis of non-ischemic central retinal vein occlusion (CRVO) presenting as a papillophlebitis in the right eye of the patient was confirmed by fluorescein angiography and optical coherence tomography.
Systemic laboratory tests were all within normal limits except for Mantoux test (PPD) which was positive, 18 mm induration and 2+ redness. Chest radiography was negative for lung tuberculosis. With the probable diagnosis of papillophlebitis secondary to tuberculosis, the patient received a course of anti-tuberculosis medications. Four weeks after initiation of treatment, the inflammation subsided and vision improved to 20/30.
Here in, we reported a rare case with PPD-positive ocular tuberculosis with no sign of a systemic infection presenting first as papillophlebitis. This report may emphasize the importance of systemic work-up in young patients come with CRVO. Furthermore, although papillophlebitis is a relatively benign condition, the differential diagnoses include a number of sight-threatening and potentially life threatening disorders which need to be excluded by medical assessment before the ultimate diagnosis is reached.