Serial swept-source optical coherence tomography: Tale of a choroidal tuberculoma

Choroidal tuberculoma is a solitary elevated choroidal mass-like lesion regarded often characteristic of intraocular tuberculosis. Serial swept-source optical coherence tomography (SS-OCT) is a very important tool in monitoring the course of choroidal tuberculoma and allows in early detection of complications such as choroidal neovascular membrane (CNVM). We describe a 26-year-old young Indian female, who presented with a solitary choroidal mass lesion in the left eye. Based on positive Mantoux test, biopsy of cervical lymph nodes showing acid-fast bacilli and radiographic findings, a diagnosis of choroidal tuberculoma was made. Serial SS-OCT during subsequent follow-up visits up to 14 months demonstrated the characterization of the lesion and assessment of response to antitubercular therapy and oral steroid. The patient was subsequently diagnosed to have concurrent CNVM and successfully treated with two anti-vascular endothelial growth factor intravitreal injections.