Three-dimensional spectral domain optical coherence tomography imaging of the retina in choroidal tuberculoma

Abstract

Introduction To study retinal imaging in choroidal tuberculoma by three-dimensional spectral domain optical coherence tomography (SD-OCT) for the first time. Methods QuantiFERON-TB GOLD test, colour Doppler imaging, fluoroscein angiography and SD-OCT were performed in an 18-year-old immunocompetent female patient. Results Three-dimensional imaging over the choroidal lesion revealed marked retinal elevation. Subfoveal neurosensory detachment along with serous retinal detachment resulted from effusion of fluid from the underlying choroidal lesion. Granularity of the outer photoreceptor layer and proliferating retinal pigment epithelium cells indicated chronicity of the underlying choroidal lesion abutting the retina. Antitubercular therapy, after 2 weeks, resulted in a resolution of the subfoveal neurosensory detachment, reduction in the serous retinal detachment and a decrease in retinal elevation. Conclusions Three-dimensional SD-OCT allows a spatial visualisation and documentation of retinal elevation. It also allows a detailed visualisation of the secondary retinal pigment epithelial and intraretinal changes and is helpful in monitoring the response to medication. Copyright 2013 BMJ Publishing Group. All rights reserved.