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Clinical features and long-term treatment outcomes in choroidal tuberculoma

Authors
 Dong Hyun Lee  ;  Hyuna Cho  ;  Junwon Lee  ;  Eun Young Choi  ;  Sung Chul Lee  ;  Min Kim 
Citation
 GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, Vol.260(5) : 1641-1650, 2022-05 
Journal Title
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
ISSN
 0721-832X 
Issue Date
2022-05
MeSH
Adult ; Antitubercular Agents / therapeutic use ; Choroid Diseases* / diagnosis ; Choroid Diseases* / drug therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Tuberculoma* / diagnosis ; Tuberculoma* / drug therapy ; Tuberculosis, Ocular* / diagnosis ; Tuberculosis, Ocular* / drug therapy
Keywords
Choroidal tuberculoma ; Eye neoplasm ; Tuberculosis ; Uveitis
Abstract
Purpose: To investigate the clinical features and treatment outcomes of patients with choroidal tuberculoma.

Methods: In this retrospective, observational case series, the medical records of five patients with choroidal tuberculoma who were followed up at a university hospital for at least 6 months were analyzed.

Results: Of five patients, one was male and four were female. The overall mean age was 38.0 ± 9.4 years (mean follow-up: 41.2 ± 33.8 months). Tuberculin skin test was performed in three patients, and it was positive in two of them. Interferon-gamma assay was performed in two patients and was positive in all two. Three patients had systemic tuberculosis involving the lung or other organs. Five patients were treated with antitubercular therapy for a period of 9.6 ± 8.6 months. Systemic corticosteroid treatment was performed in 3 patients, with a period of 3.5 ± 0.7 months. One patient with a recurrent vascularized tuberculoma was successfully treated with single intravitreal bevacizumab injection.

Conclusion: Choroidal tuberculoma can develop without evidence of systemic tuberculosis and can recur despite antitubercular treatment. High index of suspicion is important in early detection, and management of choroidal tuberculoma. In cases of suspected choroidal tuberculoma, positive results on immunological tests would be sufficient to initiate antitubercular therapy even if radiological evidence of systemic tuberculosis is not found. Antitubercular therapy combined with systemic corticosteroids provided favorable results. Intravitreal injection of anti-vascular endothelial growth factor may be considered for highly vascularized choroidal tuberculoma.
Full Text
https://link.springer.com/article/10.1007/s00417-021-05474-9
DOI
10.1007/s00417-021-05474-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Lee, Jun Won(이준원) ORCID logo https://orcid.org/0000-0003-0543-7132
Choi, Eun Young(최은영) ORCID logo https://orcid.org/0000-0002-1668-6452
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191384
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