Bilateral choroidal tuberculoma in miliary tuberculosis - report of a case

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• 作者：Radha Annamalai (1)
  Jyotirmay Biswas (2)
  
  1. Sri Ramachandra University ; Porur ; Chennai ; 600166 ; India
  2. Uveitis & Ocular Pathology Department ; Sankara Nethralaya ; 18 ; College Road ; Nungambakkam ; Chennai ; 600006 ; India
  
• 关键词：Choroidal tuberculoma ; Mycobacterium tuberculosis ; Real ; time polymerase chain reaction ; Aqueous humor ; Angiography
• 刊名：Journal of Ophthalmic Inflammation and Infection
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：5
• 期：1
• 全文大小：1,447 KB
• 参考文献：1. Thompson MJ, Albert DM (2005) Ocular tuberculosis. Arch Ophthalmol 123:844鈥?49 CrossRef
  2. Sarvananthan N, Wiselka M, Bibby K (1998) Intraocular tuberculosis without detectable systemic infection. Arch Ophthalmol 116(10):1386鈥?388
  3. Bodaghi B, LeHoang P (2000) Ocular tuberculosis. Curr Opin Ophthalmol 1(6):11443鈥?1448
  4. Levecq LJ, Potter P (2005) Solitary choroidal tuberculoma in an immunocompetent patient. Arch Ophthalmol 123(6):864鈥?66 CrossRef
  5. Cangemi FE, Friedman AH, Josephberg R (1980) Tuberculoma of the choroid. Ophthalmol 87(3):252鈥?56 CrossRef
  6. Di Loreto DA Jr, Rao NA (2001) Solitary nonreactive choroidal tuberculoma in a patient with acquired immune deficiency syndrome. Am J Ophthalmol 131(1):138鈥?40 CrossRef
  7. Han BG, Choi SO, Lee SJ, Kim YH, Hong WP, Lee JH (2001) Choroidal tuberculoma with membranous glomerulonephritis. Yonsei Med J 42:446鈥?50 CrossRef
  8. Moon S, Son J, Chang W (2008) A case of oculomotor nerve palsy and choroidal tuberculous granuloma associated with tuberculous meningoencephalitis. Koren J Ophthalmol 22(3):201鈥?04 CrossRef
  9. Jabbour NM, Faris B, Trempe CL (1985) A case of pulmonary tuberculosis presenting with choroidal tuberculoma. Ophthalmol 92:834鈥?37 CrossRef
  10. Milea D, Fardeau C, Lumbroso L, Similowski T, Lehoang P (1999) Indocyanine green angiography in choroidal tuberculomas. Br J Ophthalmol 83(6):753 CrossRef
  11. Tayanc E, Akova Y, Yilmaz G (2004) Indocyanine green angiography in ocular tuberculosis. Ocul Immunol Inflamm 12(4):317鈥?22 CrossRef
  12. Shimakawa M (2000) Choroidal tuberculoma in a patient with acquired immunodeficiency syndrome. Jpn J Ophthalmol 44(6):697 CrossRef
  13. Demirci H, Shields CL, Shields JA, Eagle RC Jr (2004) Ocular tuberculosis masquerading as ocular tumors. Surv Ophthalmol 49:78鈥?9 CrossRef
  14. Alaraj AM, Al-Dhibi H, Al-Mezaine HS, Abu El- Asrar AM (2013) Solitary presumed choroidal tuberculomas masquerading as choroidal tumors. Saudi Med J 34(1):86鈥?0
  15. Papastefanou VP, Cohen VM (2011) Tuberculoma of the choroid masquerading as a choroidal melanoma. Eye 25:1519鈥?520 CrossRef
  16. Sen A, Tugcu B, Soysal A, Yuksel B, Kocabiyik N, Arpaci B (2011) Choroidal tuberculoma in two cases with multiple intracranial tuberculomas. J Neurol Sci 28(4):609鈥?13
  17. Mansour AM, Haymond R (1990) Choroidal tuberculomas without evidence of extraocular tuberculosis. Graefes Arch Clin Exp Ophthalmol 228(4):382鈥?83 CrossRef
  18. Sharma PM, Singh RP, Kumar A, Prakash G, Mathur MB, Malik P (2003) Choroidal tuberculoma in miliary tuberculosis. Retina 23(1):101鈥?04 CrossRef
  19. Sudarshan S, Ganesh SK, Biswas J (2010) Current approach in the diagnosis and management of posterior uveitis. Ind J Ophthalmol 58(1):29鈥?4 CrossRef
  20. Yeh S, Sen HN, Colyer M, Zapor M, Wroblewski K (2012) Update on ocular tuberculosis. Curr Opin Ophthalmol 23(6):551鈥?56 CrossRef
  21. Marback EF, de Souza Mendes E Jr, Chagas Oliveira RD, Parikh JG, Rao NA (2011) Isolated uveal tuberculoma masquerading as an intraocular tumor in an immunocompetent patient鈥攁 clinical-pathologic study with diagnosis by PCR. J Ophthalmic Inflamm Infect 1:81鈥?4 CrossRef
  22. Gupta V, Gupta A, Sachdeva N, Arora S, Bambery P (2006) Successful management of tubercular subretinal granulomas. Ocul Immunol Inflamm 14(1):35鈥?0 CrossRef
  23. Santos FF, Commodaro AG, Souza AV, Pinho JR, Sitnik R, Garcia C, Ribeiro AL, Muccioli C, Lottenberg CL, Rizzo LV, Belfort Junior R (2011) Real-time PCR in infectious uveitis as an alternative diagnosis. Arq Bras Oftalmol 74(4):258鈥?61 CrossRef
  24. Abu El-Asrar AM, Abuammoh M, Al-Mezaine HS (2010) Tuberculous uveitis. Int Ophthalmol Clin 50:19鈥?9 CrossRef
  
• 刊物主题：Ophthalmology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1869-5760

文摘

Background A choroidal mass or granuloma is a feature of ocular tuberculosis (TB). Tubercles can arise in the early stages of progression of TB and indicate hematogenous dissemination before the development of symptomatic disease. Tubercular subretinal granuloma is responsive to treatment with anti-tuberculosis therapy, and prompt treatment helps resolve the lesion completely. Findings We report a case of a solitary large active choroidal tuberculoma in one eye and multiple healed tubercles in the other. The patient was an immunocompetent girl with splenic and miliary TB and had a relatively asymptomatic systemic status. Aqueous humor analysis by polymerase chain reaction (PCR) and real-time PCR (RT-PCR) was negative for the Mycobacterium tuberculosis genome. Based on clinical history and investigations, treatment with four-drug regimen of anti-tubercular treatment with concomitant corticosteroids was started, and total healing of the lesion occurred in 3 months. Conclusions This case highlights the fact that in some patients, analysis of the aqueous may not provide any clue to the confirmation of an active tubercular choroidal granuloma and an association between splenic tuberculosis and choroidal tubercles has never been reported in the past.