Abstract:

Objective To observe the clinical features and treatment outcomes of choroidal tuberculoma. Design Retrospective case series. Participants The 7 cases (7 eyes) with choroidal tuberculoma presented to Beijing Tongren Hospital between June 2012 and June 2018. In the 7 patients, 4 were male and 3 were female. Method Best corrected visual acuity, slit lamp ophthalmoscopy, indirect ophthalmoscopy，fundus fluorescein angiography(FFA), indocyanine green fundus angiography (ICGA), optical coherence tomography(OCT), B ultrasound, computed tomography of the chest, Interferon-gamma release assay (IGRA) and Purified Protein Derivative(PPD)were performed. All patients had standard anti-tuberculosis treatment. Treatment outcomes were followed for 6 to 18 months with an average of (11.1±3.8) months. Main Outcome Measures Visual acuity, features of the fundus, FFA and ICGA. Results The average age of 7 cases was (42±11.5) years-old. Three patients had active pulmonary tuberculosis, 2 patient had history of tuberculosis，1 patient had the history of contact with tuberculosis, and 1 patient was latent tuberculosis infection. All cases were affected unilaterally. Six patients had solitary granuloma and 1 patient had multiple granuloma. Fundus examination showed 7 eyes with subretinal yellow-white lesions and exudative retinal detachment. Five eyes presented with retinal hemorrhage. Baseline visual acuity ranged from hand motion to 0.5. In FFA，2 eyes demonstrated hypofluorescence in the early stage and hyperfluorescence in the late stage，while 5 eyes revealed hyperfluorescence in the early stage and fluorescence leakage in the late stage. Needle-like high fluorescein spots were found in the margins of the lesions in 4 cases. ICGA revealed hypofluorescentce in the early phase and hyperfluorescence with obscure boundary in the late phase. After standard anti-tuberculosis treatment（the course of treatment was 6 to 18 months），inflammation was controlled at the end of follow-up in all cases. Conclusion Choroidal tuberculoma can associate with active or inactive pulmonary tuberculosis, or latent tuberculosis infection. The main presentations of choroidal tuberculoma are subretinal yellow-white lesions at the posterior pole, and exudative retinal detachment. Standard anti-tuberculosis treatment can improve ocular inflammation. （Ophthalmol CHN， 2019, 28： 336-340）

Key words: choroidal tuberculoma, anti-tuberculous treatment