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Year : 2020  |  Volume : 68  |  Issue : 9  |  Page : 2040-2043

Coats-like response in tubercular subretinal abscess masquerading as melanoma as the initial manifestation of miliary tuberculosis

1 Department of Uvea, Sankara Nethralaya, Chennai, Tamil Nadu, India
2 Department of Vitreoretina, Sankara Nethralaya, Chennai, Tamil Nadu, India
3 Department of Ocular Oncology and Vitreoretina, Sankara Nethralaya, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. S Sudharshan
Sankara Nethralaya, 41, College Road, Chennai - 600 006, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_968_20

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Ocular neoplasia can masquerade as an inflammatory condition and vice-versa, which if untreated, can lead to loss of vision or even life. We present a young immunocompetent adult male referred to us as choroidal melanoma. He had a large atypical choroidal mass and exudative retinal detachment. He had no systemic complaints and ocular lesions were the first manifestation of disseminated disease. Aqueous polymerase chain reaction for Mycobacterium tuberculosis (MTB) was negative, but Mantoux, chest radiology, acid-fast bacilli, and caseation necrosis on pleural nodule histopathology confirmed tuberculosis (TB). While on antitubercular therapy, a rare “Coats'-like response” was noted which eventually resolved completely with treatment.

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