Tubercular retinal vasculitis mimicking frosted branch angiitis: a case report

Tubercular vasculitis is an important manifestation of ocular tuberculosis and this report highlights the mimicking nature of the disease with frosted branch angiitis. A patient presented with a severe form of retinal vasculitis in both eyes and a branch retinal vein occlusion in the left eye. He had a positive tuberculin skin test (TST) and a raised erythrocyte sedimentation rate (ESR) and serum angiotensin-converting enzyme (ACE) levels. Radiological investigations revealed a sub-pleural nodule and mediastinal lymph nodes, which on histopathological evaluation confirmed a granulomatous etiology. Retinal vasculitis secondary to tubercular etiology may mimic a viral vasculitis; however, a clinical suspicion with a timely diagnosis and management helps in preventing loss of vision and the eye.