{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:50Z","timestamp":1756339550004,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,16]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 26-year-old man presented with diminution of vision in the left eye associated with malaise and occasional mild fever. On fundus examination, the patient had left eye inferior bullous retinal detachment with choroidal granuloma. Systemic examination revealed a non-tender swelling on the right wrist. Correlating ophthalmic and systemic findings, a presumptive diagnosis of left eye exudative retinal detachment with choroidal tuberculoma and tubercular osteomyelitis of the right wrist was made. On imaging, asymptomatic multiorgan involvement was observed in the chest, abdomen and spine. The patient was started on antitubercular treatment along with peribulbar steroid. A reduction in size of exudative retinal detachment and tuberculoma with improvement in vision was noted on serial follow-ups. This case highlights the importance of thorough systemic evaluation in cases of ocular tuberculosis as the eye may not be the primary site but the early presenting feature of disseminated tuberculosis. Local posterior subtenon can be used for faster resolution of exudative retinal detachment and intraocular inflammation.<\/jats:p>","DOI":"10.1136\/bcr-2020-241179","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T12:26:13Z","timestamp":1617193573000},"page":"e241179","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Large exudative retinal detachment with choroidal granuloma unmasking disseminated tuberculosis: imaging and management"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9737-6706","authenticated-orcid":false,"given":"Anusha","family":"Sachan","sequence":"first","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Chawla","sequence":"additional","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2218-3130","authenticated-orcid":false,"given":"Suman","family":"Lata","sequence":"additional","affiliation":[{"name":"Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"2025082710490542000_14.3.e241179.1","unstructured":"Tuberculosis India 2010 . Annual report of the revised national tuberculosis ControlProgramme. New Delhi: Central Tuberculosis Division Directorate General of Health Services, Ministryof Health and Family Welfare, Government of India, 2010."},{"key":"2025082710490542000_14.3.e241179.2","unstructured":"Iseman MD . Extrapulmonary tuberculosis in adults. In: A Clinician\u2019s Guide to Tuberculosis. 1st edn. Philadelphia: Lippincott Williams &Wilkins, 2000."},{"key":"2025082710490542000_14.3.e241179.3","doi-asserted-by":"crossref","first-page":"997","DOI":"10.7326\/0003-4819-5-8-997","article-title":"The clinical significance of choroidal Tubercles*","volume":"5","author":"Paton","year":"1932","journal-title":"Ann Intern Med"},{"key":"2025082710490542000_14.3.e241179.4","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.6.844"},{"key":"2025082710490542000_14.3.e241179.5","first-page":"1386","article-title":"Intraocular tuberculosis without detectable systemic infection","volume":"116","author":"Sarvananthan","year":"1998","journal-title":"Arch Ophthalmol"},{"key":"2025082710490542000_14.3.e241179.6","doi-asserted-by":"publisher","DOI":"10.1186\/s12348-014-0032-x"},{"key":"2025082710490542000_14.3.e241179.7","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/cxo.12576","article-title":"Massive choroidal granuloma as the presenting feature of disseminated tuberculosis in immunocompetent patients","volume":"101","author":"Goel","year":"2018","journal-title":"Clin Exp Optom"},{"key":"2025082710490542000_14.3.e241179.8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/0301-4738.58470","article-title":"Current approach in the diagnosis and management of posterior uveitis","volume":"58","author":"Sudharshan","year":"2010","journal-title":"Indian J Ophthalmol"},{"key":"2025082710490542000_14.3.e241179.9","article-title":"Choroidal tuberculoma","volume":"29","author":"Tripathy","year":"2016","journal-title":"Natl Med J India"},{"key":"2025082710490542000_14.3.e241179.10","doi-asserted-by":"crossref","first-page":"100969","DOI":"10.1016\/j.ajoc.2020.100969","article-title":"Choroidal granuloma resolution with tuberculosis treatment","volume":"20","author":"Young","year":"2020","journal-title":"Am J Ophthalmol Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:49:14Z","timestamp":1756316954000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,31]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-241179"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241179","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}