Tuberculoma of the choroid

Area of Science:

• Ophthalmology
• Infectious Diseases
• Tuberculosis Research

Background:

• Ocular tuberculosis is a rare but serious manifestation of Mycobacterium tuberculosis infection.
• Pulmonary tuberculosis is the most common source of systemic dissemination leading to ocular involvement.
• Early diagnosis and treatment are crucial to prevent vision loss.

Observation:

• A 22-year-old male with known active pulmonary tuberculosis presented with sudden, severe unilateral vision loss.
• Ophthalmic examination revealed a choroidal tuberculoma, a granulomatous lesion caused by tuberculosis.
• Serial fundus photography and fluorescein angiography were utilized for diagnosis and monitoring.

Findings:

• The choroidal tuberculoma showed significant resolution following initiation of standard antituberculous therapy.
• Fluorescein angiography demonstrated characteristic patterns of choroidal tuberculoma, aiding in diagnosis.
• This case highlights the efficacy of timely antituberculous treatment in managing ocular manifestations.

Implications:

• Choroidal tuberculoma should be considered in the differential diagnosis of vision loss in patients with active tuberculosis.
• Fluorescein angiography is a valuable tool for diagnosing and monitoring ocular tuberculosis, despite infrequent use.
• Prompt treatment of ocular tuberculosis can prevent irreversible vision impairment and systemic complications.