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Evidence and Consensus-Based Imaging Guidelines in Tubercular Choroiditis: Multimodal Imaging in Uveitis (MUV) Task
Timothy M Janetos1, Aniruddha Agarwal2, Jyotirmay Biswas3
1Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Ophthalmology. Retina
|June 29, 2026
Summary
Multimodal imaging guidelines for tubercular choroiditis (TBC) were developed by experts. These consensus recommendations standardize diagnosis, monitoring, and complication detection for TBC using advanced imaging techniques.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Medical Imaging
Background:
- Tubercular choroiditis (TBC) diagnosis and monitoring can be challenging.
- Standardized imaging criteria are needed for consistent evaluation of TBC.
- Multimodal imaging offers comprehensive insights into ocular pathologies.
Purpose of the Study:
- To establish consensus-based imaging statements and recommendations for multimodal imaging in tubercular choroiditis.
- To develop standardized criteria for diagnosing and monitoring TBC using various imaging modalities.
- To guide the application of advanced imaging techniques in the clinical management of TBC.
Main Methods:
- An international expert committee utilized a modified nominal group technique (NGT) and literature review.
- A comprehensive portfolio of 31 TBC cases (active and inactive) was reviewed.
- Consensus was achieved on descriptive imaging features using color fundus photography, FAF, FFA, ICGA, OCT, and OCTA.
Main Results:
- Distinct imaging features for tubercular serpiginous-like choroiditis (TB SLC) and choroidal tuberculomas/tubercles were defined.
- Active TB SLC lesions show specific characteristics on FAF and OCT.
- Choroidal tuberculomas and tubercles have identifiable features on multimodal imaging, aiding differentiation.
Conclusions:
- The developed guidelines integrate multimodal imaging for TBC characterization and monitoring.
- These recommendations enhance phenotypic classification and assessment of disease activity in TBC.
- The consensus guidelines provide clinically relevant endpoints for treatment response evaluation in TBC.
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