Tuberculous Uveitis Presenting with a Bullous Exudative Retinal Detachment: A Case Report and Systematic Literature Review

Ocul Immunol Inflamm. 2019;27(6):998-1009. doi: 10.1080/09273948.2018.1485958. Epub 2018 Jul 3.


Purpose: To describe tuberculous uveitis (TU) presenting as a bullous retinal detachment (RD) and to perform a comprehensive literature review on TU with similar features. Methods: Observational case report and systematic literature review. Results: An 84-year-old woman presented with bilateral granulomatous uveitis and bullous RD in the left eye. The interferon gamma release assay was strongly positive, but all other tests were unremarkable. The patient was diagnosed with TU and started on anti-tubercular therapy (ATT) and systemic steroids with excellent treatment response. Twenty-six articles (32 cases) reported TU with exudative RD. Choroidal tuberculoma was the most common clinical manifestation, followed by optic disc edema and retinal exudate. Systemic steroids with ATT improved vision in more patients (78.6%) than ATT alone (50.0%) or oral steroids followed by ATT (50.0%). Conclusion: Atypical presentations of TU make diagnosis and treatment difficult. A high level of suspicion for TU is needed to minimize ocular morbidity.

Keywords: Anti-tubercular therapy; choroiditis; ocular tuberculosis; retinal detachment; tuberculosis; uveitis.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Female
  • Fluorescein Angiography
  • Granuloma / diagnosis
  • Granuloma / drug therapy
  • Granuloma / microbiology
  • Humans
  • Interferon-gamma Release Tests
  • Mycobacterium tuberculosis / isolation & purification
  • Retinal Detachment / diagnosis*
  • Retinal Detachment / drug therapy
  • Retinal Detachment / microbiology
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / microbiology
  • Uveitis / diagnosis*
  • Uveitis / drug therapy
  • Uveitis / microbiology


  • Antitubercular Agents