Unilateral snow banking in tuberculosis-related intermediate uveitis
© Babu and Bhat; licensee Springer. 2014
Received: 5 January 2014
Accepted: 3 February 2014
Published: 10 February 2014
Snow banking is usually a term coined to describe the accumulation of vitreous exudates over the pars plana and the peripheral retina in pars planitis. Snow banking is very rare in tubercular intermediate uveitis. A 32-year-old male was diagnosed to have intermediate uveitis due to tubercular etiology in the right eye. Laboratory investigations include an increased erythrocyte sedimentation rate, positive Mantoux test, and computed tomography thorax showing mediastinal lymphadenopathy. Transbronchial needle aspiration of the lymph nodes showed chronic granulomatous inflammation with caseation. There were no recurrences following antitubercular therapy (ATT). This case report highlights the unique finding of snow banking in tubercular uveitis and course following treatment with ATT.
KeywordsIntermediate uveitis Snow banking Tuberculosis Antitubercular therapy
Snow banking is usually a term coined to describe the accumulation of white or cream vitreous exudates over the pars plana and the peripheral retina in pars planitis. It has also been described in intermediate uveitis due to Lyme disease, sarcoidosis, and multiple sclerosis[1–3]. Snow banking is very rare in tubercular intermediate uveitis. In this case report, we report an interesting finding of snow banking in tubercular intermediate uveitis and the response to antitubercular therapy (ATT).
Intermediate uveitis is generally believed to be autoimmune in nature, and snow banking is an important clinical sign of intermediate uveitis[1–3]. In tuberculosis-endemic countries like India, tuberculosis is an important etiologic cause of intermediate uveitis. Snow banking is generally described in intermediate uveitis due to autoimmune etiology and has not been described frequently in tubercular uveitis. This case report highlights the rare finding of snow banking in tubercular uveitis. It is important to investigate intermediate uveitis for tuberculosis even if snow banking is seen as specific antitubercular therapy helps in reducing the recurrences significantly.
KB is a senior consultant in the Department of Uveitis and Intraocular Inflammation at Prabha Eye Clinic & Research Centre and Vittala International Institute of Ophthalmology, Bangalore. SSB is a junior fellow in the Department of Uveitis and Intraocular Inflammation at Prabha Eye Clinic & Research Centre and Vittala International Institute of Ophthalmology, Bangalore.
best corrected visual acuity
Transbronchial needle aspiration.
- Lai WW, Pulido JS: Intermediate uveitis. Ophthalmol Clin North Am 2002,15(3):309–317. Review 10.1016/S0896-1549(02)00026-3View ArticlePubMedGoogle Scholar
- Breeveld J, Rothova A, Kuiper H: Intermediate uveitis and Lyme borreliosis. Br J Ophthalmol 1992,76(3):181–182. 10.1136/bjo.76.3.181PubMed CentralView ArticlePubMedGoogle Scholar
- Nussenblatt RB, Palestine AG: Intermediate uveitis and pars planitis. In Uveitis: fundamentals and clinical practice. Edited by: Nussenblatt RB, Palestine AG. Chicago: Year Book; 1989:185–197.Google Scholar
- Jabs DA, Nussenblatt RB, Rosenbaum JT: Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data: results of the first international workshop. Am J Ophthalmol 140(3):509–516. Review
- Parchand S, Tandan M, Gupta V, Gupta A: Intermediate uveitis in Indian population. J Ophthalmic Inflamm Infect 2011,1(2):65–70. 10.1007/s12348-011-0020-3PubMed CentralView ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.