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

Background: 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, fluorescein 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.