CHOROIDAL TUBERCULOMA ISOLATED: CASE REPORT
The purpose of this study is to present a case of choroidal tuberculoma and to show the importance of a correct and early diagnosis in our daily clinical practice.
Presentation of a clinical case.
A 36-year-old patient with a history of low visual acuity in the right eye for 3 days, followed by a sudden onset metamorphism. The diagnosis of choroidal tuberculoma was established through the clinical findings and the positive tuberculin quantification test (20 mm). The treatment for tuberculosis with the RIPE regimen (rifampicin, isoniazid, pyrazinamide and ethambutol) was promptly initiated and after two months was modified for the association of rifampicin with isoniazid. After five months of treatment, the patient presented complete healing of the choroidal granuloma and regression of the serous retinal detachment observed, accompanied by improvement of visual acuity, which increased from 20/100 to 20/20 in the right eye with its best correction.
The diagnosis of ocular tuberculosis is presumptive in most cases due to the difficulty of isolating the agent. It is based on clinical findings through the appearance of ocular lesions, systemic evidence of tuberculosis and propaedeutic confirmation through PPD, radiological and histopathological examinations. Injury biopsy or vitreous or aqueous aspirate polymerase chain reaction are more advanced methods that aid in the diagnosis,
Tuberculosis, Choroidal Tuberculoma, Early Diagnosis,RIPE
CLINICAL RETINA
HOSPITAL CEMA - São Paulo - Brasil
Antonio Sergio Franca Neves, Natalia Carolina Santos Silva, Carla Canevari, Eduardo Henrique Pelegrini, Fernanda Paccini Alves Godoi, Jose Antonio Macedo Orbezo, Lais Orrico Di Stasi, Thomas Edson Ferreira Oliveira Silva