CSR or TB?
The article "Oral rifampin utilisation for the treatment of chronic multifocal central serous retinopathy(CSR)"1 by Steinle NC et al is very informative. However a few points require further elaboration. We were told that patient is an African -American but for how long he stayed in Africa and how frequently he or any of his close family members visit any tuberculosis (TB) endemic area? As both CSR and ocular TB are poorly understood diseases, there is a possibility that these were confused with each other or TB was the underlying pathology in this condition which resembled CSR. Furthermore Rifampin did not cure the disease and its discontinuation led to recurrence which is also true in incomplete TB treatment. Recommendations in this case include an appropriate test like QuantiFERON-TB Gold2 or polymerase chain reactions (PCR) of vitreous, to rule out TB and a full six month course of anti TB3 to avoid recurrences. References: 1. Steinle NC, Gupta N, Yuan A, Singh RP. Oral rifampin utilisation for the treatment of chronic multifocal central serous retinopathy. Br J Ophthalmol. 2012 Jan;96(1):10-3. 2. Gineys R, Bodaghi B, Carcelain G, Cassoux N, Boutin le TH, Amoura Z, Lehoang P, Trad S. QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol. 2011 Sep;152(3):433-440.e1 3. Sanghvi C, Bell C, Woodhead M, Hardy C, Jones N. Presumed tuberculous uveitis: diagnosis, management, and outcome. Eye (Lond). 2011 Apr;25(4):475-80.
Conflict of Interest:
Register for free content
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of BJO.
View free sample issue >>
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.