Diagnosis of Optochiasmatic Tuberculosis Revealed by Computed Tomography and Magnetic Resonance Imaging

A woman had a sudden painful decrease in vision in the left eye and then the right eye. Computed tomography and magnetic resonance imaging revealed a “ring” lesion in the right parietal lobe. Further testing and a past history of pulmonary tuberculosis led to a diagnosis of optochiasmatic tuberculosis. Antitubercular treatment led to dramatically improved vision and a radiologic resolution. Although rare, optochiasmatic tuberculosis should be considered in the differential diagnosis of nonspecific optic neuritis and optic nerve and chiasmal tumors.