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Clinical features and long-term treatment outcomes in choroidal tuberculoma

  • Inflammatory Disorders
  • Published:
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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.

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Availability of data and materials

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

None.

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Funding

This study was supported by a faculty research grant from Yonsei University College of Medicine [grant number 2017–32-0037]. This research was supported by the Korean Association of Retinal Degeneration.

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Authors and Affiliations

  1. Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonju-ro, Gangnam-gu, Seoul, Republic of Korea, 06273

    Dong Hyun Lee, Hyuna Cho, Junwon Lee & Min Kim

  2. Department of Ophthalmology, Inha University Hospital, Inha University College of Medicine, 27, Inhangro, Jung-gu, Incheon, Republic of Korea

    Dong Hyun Lee

  3. Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea

    Eun Young Choi

  4. Department of Ophthalmology Konyang University Hospital, Konyang University College of Medicine, 158, Gwanjeodongro, Seo-gu, Daejeon, Republic of Korea

    Sung Chul Lee

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  1. Dong Hyun Lee
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Contributions

DHL, JL, and MK developed the study concept and design, as well as analyzed and interpreted the data. DHL and HC participated in data collection. DHL and MK drafted the manuscript. DHL, JL, EYC, SCL, and MK critically revised the manuscript. SCL and MK supervised the study. All the authors have read and approved the final manuscript.

Corresponding author

Correspondence to Min Kim.

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Ethics approval

This study was conducted in accordance with the tenets of the Declaration of Helsinki, and was approved by the Institutional Review Board of the Gangnam Severance Hospital (IRB approval number: 3–2020-0094).

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The informed consent was waived.

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The informed consent was waived.

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The authors declare no competing interests.

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Lee, D.H., Cho, H., Lee, J. et al. Clinical features and long-term treatment outcomes in choroidal tuberculoma. Graefes Arch Clin Exp Ophthalmol 260, 1641–1650 (2022). https://doi.org/10.1007/s00417-021-05474-9

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  • DOI: https://doi.org/10.1007/s00417-021-05474-9

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