Dr.MERIN JACOB, M21613
To report a case of subretinal mass in a patient with disseminated TB mimicking amelanotic melanoma
A 25 year old male presented with complaints of sudden diminision of vision,pain and redness in right eye since 1 month. MRI done elsewhere was suggestive of amelanotic choroidal melanoma with suspicious metastatic lesion of left parietal cortex. BCVA in right eye was CFCF. Ocular examination revealed anterior chamber reaction 1+, vitreous cells, a large subretinal mass inferotemporally with exudative retinal detachment involving macula. Mantoux test was positive. AC tap was negative for PCR MTB. Pleural fluid cytology, CT chest confirmed disseminated TB and ruled out melanoma. Patient was treated with a 9 month course of ATT and systemic steroids. At 1 year followup, UCVA improved to 6/18, N6 with complete resolution of lesion
CONCLUSION: TB subretinal abscess can present with a large mass mimicking amelanotic melanoma. MRI may be suspicious. Pleural biopsy can clinch the diagnosis
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