Solitary presumed choroidal tuberculomas masquerading as choroidal tumors

Abstract

The ocular involvement of tuberculosis is not uncommon but diverse. Rarely, patients initially present with ocular signs that simulate intraocular malignancy. We report 3 cases of isolated presumed choroidal tuberculoma masquerading as intraocular tumor. Two patients had no systemic evidence of tuberculosis with strongly positive purified protein derivative skin test and one patient had evidence of inactive old pulmonary tuberculosis demonstrated by chest computed tomography. Antituberculous regimen including isoniazid 5 mg/kg/day, rifampicin 600 mg/day, ethambutol 15 mg/kg/day, and pyrazinamide 30 mg/kg/day were employed in all cases for 9 months. In addition, oral prednisone 1 mg/kg/day has been given until clinical response was seen, then slowly tapered over 4 months until discontinued. All cases responded well to treatment without complications. Ocular tuberculosis may show challenging clinical presentations, and proper diagnosis and treatment can save the patient's eye and even life.