Photodynamic Therapy for the Treatment of Vascularized Intraretinal Tuberculoma

Abstract

Purpose: To report a case of intraretinal tubercular granuloma successfully treated with photodynamic therapy (PDT).

Methods: Retrospective case report. Multimodal imaging was performed at each follow-up visit.

Results: The tuberculoma did not regress and did not significantly reduce its exudation after anti-tubercular therapy (ATT), systemic steroid therapy and intravitreal anti-VEGF. Second line treatment with PDT was attempted. The lesion showed a regression with reduced sub-retinal fluid and intra-retinal exudates. A second PDT was performed for reactivation of the lesion 5 months after the first treatment. Further regression of the lesion was observed.

Conclusion: PDT may be a valuable second-line therapeutic approach for vascularized intraretinal granulomas.

Keywords: Multimodal imaging; PDT; photodynamic therapy; pseudomelanoma; retinal granuloma; tuberculoma; tuberculosis; uveitis.