A 42-year-old man was detected HIV positive two years ago. He is currently on HAART and was initiated on anti-tuberculous therapy 2 months ago following detection of acid fast bacilli in sputum. Culture of the sputum sample grew Mycobacterium tuberculosis. He came for his follow up visit with complaints of diminished vision and significant loss of weight. His sputum was reassessed and remained positive for acid fast bacilli. A drug susceptibility testing of the initial isolate was ordered and the results are awaited. CD4+ counts were 545 cells.
Chest X-ray showed advanced tuberculosis. On examination, visual acuity is reduced in both eyes. Opthalmoscopic picture is shown. What is the probable cause of the visual abnormality? Source: Banker, Alay S. Indian Journal of Ophthalmology 56.5 (2008): 377–383. Print.
