Resolution of Large Choroidal Tuberculoma following Monotherapy with Intravitreal Ranibizumab

Ocul Immunol Inflamm. 2020 Apr 2;28(3):494-497. doi: 10.1080/09273948.2019.1582786. Epub 2019 Apr 15.

Abstract

Background: Ocular tuberculosis can have protean manifestations. Anti-tubercular therapy (ATT) and oral steroids are employed in the management of this condition. There is evidence in the literature which has highlighted the use of intravitreal anti-vascular endothelial growth factor drugs as an adjunct to systemic therapy.Report of the Case: A 44-year-old male presented with a decrease of vision in the right eye was diagnosed choroidal tuberculoma with massive exudation and subretinal fluid. The patient was treated with intravitreal ranibizumab injection. The lesion regressed completely within 6 weeks without any additional systemic corticosteroids and ATT without any recurrence over 6 months during follow-up.Conclusions: Ranibizumab monotherapy may lead in complete regression of vascularized tubercular choroidal granulomas without the need of adjunctive ATT and corticosteroids. After intravitreal injection of ranibizumab, the lesion may be observed for regression over several weeks.

Keywords: Anti-VEGF; choroidal granuloma; ranibizumab; tubercular uveitis; tuberculoma.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / administration & dosage
  • Choroid / diagnostic imaging*
  • Choroid / microbiology
  • Choroid Diseases / diagnosis
  • Choroid Diseases / drug therapy*
  • Choroid Diseases / microbiology
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Mycobacterium tuberculosis / isolation & purification
  • Ranibizumab / administration & dosage*
  • Tomography, Optical Coherence
  • Tuberculoma / diagnosis
  • Tuberculoma / drug therapy*
  • Tuberculoma / microbiology
  • Tuberculosis, Ocular / diagnosis
  • Tuberculosis, Ocular / drug therapy*
  • Tuberculosis, Ocular / microbiology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab