Intraretinal Abscess in Ocular Brucellosis: A Rare and Unusual Manifestation

PURPOSE: To present a rare case of brucellosis with intraretinal abscess formation, highlighting its atypical ocular presentation, diagnostic challenges, and therapeutic response. METHODS: A single case report of a 52-year-old woman with sudden visual loss in the left eye, supported by multimodal imaging and systemic evaluation. RESULTS: The patient presented with decreased visual acuity and retinal lesions suggestive of inflammatory pathology. Optical coherence tomography (OCT) revealed an intraretinal solid lesion with associated fluid. Despite negative initial serologic screening and Rose-Bengal test, empirical treatment with doxycycline and rifampicin was initiated based on clinical suspicion and Brucella IgG positivity. Over time, visual acuity improved significantly, with radiologic and serologic findings supporting the diagnosis of ocular brucellosis; also, cerebrospinal fluid analysis on day 20 confirmed neurobrucellosis. CONCLUSION: This case demonstrates that brucellosis, though rarely affecting the retina, can present as an intraretinal abscess even in the absence of early serologic confirmation. In endemic regions, brucellosis should be considered in the differential diagnosis of atypical retinal lesions. Prompt empirical therapy may prevent permanent visual loss.