Intraocular Tuberculosis with Extraocular Growth

A 24-year-old man presented with a 1-month history of deterioration in the vision of his left eye. Visual acuity was measured at 8/20 in the left eye and 20/20 in the right eye. In the left eye, a hemispherical subretinal mass with retinal hemorrhage was noted in the superotemporal quadrant (Figure 1 A). Interferon-gamma (IFN-gamma) release assay showed significantly elevated level of IFN-gamma. A diagnosis of intraocular tuberculosis was suspected. Physical examination showed no other abnormalities and chest radiograph was normal, so the patient refused to receive antituberculosis medications. The lesion grew quickly, and invasively spread outside the eyeball (Figure 1 B). Enucleation had to be performed and histopathological examination confirmed an intraocular tuberculosis (Figure 1 C).