Bilateral Optic Neuropathy as First Manifestation of Tuberculosis

Authors

  • Luís Rufo Costa Neurology department, Local Health Unit of Alto Minho, Viana do Castelo, Portugal https://orcid.org/0000-0003-2409-5588
  • Rui Pedro Silva Ophthalmology department, Local Health Unit of Braga, Braga, Portugal
  • Sara Gomes Neurology department, Local Health Unit of Braga, Braga, Portugal
  • Isabel Amorim Neurology department, Local Health Unit of Braga, Braga, Portugal
  • Ana Filipa Santos Neurology department, Local Health Unit of Braga, Braga, Portugal
  • Gonçalo Cação Neurology department, Local Health Unit of Alto Minho, Viana do Castelo, Portugal
  • Cristina Almeida Ophthalmology department, Local Health Unit of Braga, Braga, Portugal
  • Célia Machado Neurology department, Local Health Unit of Braga, Braga, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/195/2025

Keywords:

Antitubercular Agents, Immunocompromised Host, Mycobacterium tuberculosis, Optic Neuritis

Abstract

Intraocular tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection. We present a case of an immunocompetent male who presented with subacute binocular vision loss. On examination, he had a visual acuity of 6/10 bilaterally and optic disk edema. Initial workup was negative for structural, autoimmune, infectious or toxic etiologies. He was first treated with methylprednisolone, plasma exchange and intravenous immunoglobulin, without any clinical improvement. On the 20th day of admission, intraocular tuberculosis was presumed due to a positive interferon gamma release assay and chest tomography showing previous infection with Mycobacterium tuberculosis. He was started on an anti-tuberculosis drug regimen for 12 months, without any worsening of his visual acuity.

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Published

2026-01-04

How to Cite

1.
Rufo Costa L, Silva RP, Gomes S, Amorim I, Santos AF, Cação G, et al. Bilateral Optic Neuropathy as First Manifestation of Tuberculosis. Sinapse [Internet]. 2026 Jan. 4 [cited 2026 Jan. 8];25(4):200-4. Available from: https://sinapse.pt/index.php/journal/article/view/195

Issue

Vol. 25 No. 4 (2025): October - December

Section

Case Reports

License

Copyright (c) 2026 Luís Rufo Costa, Rui Pedro Silva, Sara Gomes, Isabel Amorim, Ana Filipa Santos, Gonçalo Cação, Cristina Almeida, Célia Machado

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.