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Letter
Tuberculous intraocular infection presenting with pigmented hypopyon: a clinicopathological case report
  1. S R Rathinam1,
  2. N A Rao2
  1. 1Aravind Eye Hospital, Madurai, India
  2. 2A Ray Irvine Ocular Pathology Laboratory, Doheny Eye Institute, Los Angeles, CA, USA
  1. Correspondence to: S R Rathinam Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar Madurai 625 020, Tamil Nadu, India; rathinamaravind.org

http://dx.doi.org/10.1136/bjo.2003.029124

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    Tuberculosis still remains a major cause of morbidity and mortality today. Globally the incidence of this disease is increasing by eight million new cases annually and is a cause of death for two to three million patients every year.1 The ocular manifestations of tuberculosis are diverse, and depend on the immunological, bacteriological, and epidemiological variables.2 Individuals with compromised immune status usually present with atypical presentations.3 This clinicopathological report of a patient treated with immunosuppressive agents shows intraocular tuberculosis presenting with pigmented hypopyon.

    A 38 year old female patient with a history of polyarthralgia, anaemia, hypertension, and an impaired renal function with a possible clinical diagnosis of systemic lupus nephropathy underwent renal biopsy, which disclosed membranous glomerulonephropathy with peripheral granular deposits of IgG, Clq, and IgM on immunofluorescence. Her erythrocyte sedimentation rate was elevated (74 mm in the first hour) and she had positive antinuclear antibody; negative rheumatoid factor, VDRL, HIV, and tuberculin skin test (PPD). She was treated with intravenous cyclophosphamide 1 g per day once every month for 3 months and corticosteroids 30 mg/day. At the time of the third intravenous injection of cyclophosphamide, …

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    Footnotes

    • Supported in part by Research to Prevent Blindness Inc, New York, NY, USA and core grant EYO3040 from the National Institute of Health, Bethesda, MD and Aravind Medical Research Foundation, Tamil Nadu, India