DR. AMBER DUBEY

DR.SUBHAM SINHA ROY

Abstract

A 32 year old male presented with bilateral diminution of vision since 5 days. On examination, his best corrected visual acuity was 6/18 in right eye and CF 1m in left eye. While his anterior segment in both eyes was unremarkable, posterior segment revealed bilateral multifocal chorioretinitis associated with exudative retinal detachment and disc oedema, morphologically simulating viral retinitis. Serological tests including PCR for VZV,HSV, and CMV were negative, which left us in a diagnostic dilemma. Hence, the need for further systemic investigations seemed prudent, which revealed positive VDRL and TPHA titres. The patient was advised a treatment protocol comprising of inj benzathine penicillin and oral steroids which rendered a dramatic response. At 2 weeks his BCVA was 6/9 in right eye and 6/18 in left eye which at 6-month follow up improved to 6/6 in both eyes with complete resolution of lesions. An extensive investigative panel can aid in diagnosing ambiguous/unresponsive cases.