scholarly journals Managing solitary choroidal tuberculoma in an immunocompetent patient

2020 ◽  
Vol 10 (5) ◽  
pp. 124-125
Author(s):  
Abhinav Dhami ◽  
Nimrata bajaj Dhami ◽  
Ravinder kaur Malhi ◽  
Gobinder Singh Dhami
Keyword(s):  
Triamcinolone Acetonide ◽  
Oral Therapy ◽  
Subretinal Fluid ◽  
Visual Outcome ◽  
Immunocompetent Patient ◽  
Mantoux Test ◽  
Intravitreal Triamcinolone ◽  
Choroidal Granuloma ◽  
Anti Tubercular Therapy ◽  
Choroidal Tuberculoma

Aim: We describe a case of young immunocompetent 18-year-old female patient who presented with sudden painless diminution of vision in left eye with vision of 20/100 on Snellen’s chart. Retinal evaluation showed a massive solitary choroidal granuloma. A positive Mantoux test (20X20 mm) was noted. The patient was started on anti-tubercular therapy and oral steroids and showed resolution of the granuloma with subretinal fluid at macula. After 3 months of oral therapy, the persistent subretinal fluid was managed with intravitreal injection of triamcinolone acetonide(2 mg). This case highlights favorable resolution of granuloma with oral therapy and a safer efficacy of triamcinolone acetonide in treating subretinal fluid due to choroidal tuberculoma with good visual outcome. Introduction: Choroidal tuberculoma is a rare ocular form of tuberculosis (TB) and is a diagnostic and a therapeutic challenge, especially when occurring without other manifestations of the disease.1,2 Involvement of the choroid occurs by direct infection or indirect immune‐mediated hypersensitivity and is the commonest clinical manifestation of intraocular TB.3 The presentation varies from a solitary choroidal granuloma (tuberculoma) to multiple choroidal tubercles, a subretinal abscess or choroiditis. We present a case of an immunocompetent patient, who presents with massive choroidal granuloma and responded to oral antitubercular and steroid therapeutic regimen. Visual acuity improved with intravitreal triamcinolone acetonide injection which resulted in resolution of subretinal fluid after 3 months

Treatment of Probable Vogt-Koyanagi-Harada with Single Intravitreal Triamcinolone Acetonide

2020 ◽  
Author(s):  
Meghana Kalavar ◽  
Nimesh A Patel ◽  
Hasenin Al-Khersan ◽  
Anibal Ale ◽  
Nicolas A Yannuzzi ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Subretinal Fluid ◽  
Term Treatment ◽  
Short Term Treatment ◽  
Intravitreal Triamcinolone ◽  
Full Field ◽  
Intravitreal Triamcinolone Acetonide ◽  
Ocular Manifestations ◽  
History Of ◽  
The Right

Abstract Background A 36-year-old woman with a history of poorly controlled diabetes was diagnosed with probable Vogt-Koyanagi-Harada (VKH). We are reporting the use of intravitreal triamcinolone acetonide (0.4 mg) to both eyes to successfully treat the ocular manifestations of VKH.Findings Nine days after injection, subretinal fluid in the right eye improved and 13 days later, the serous detachment had almost completely resolved. One month after injections, both the right and left eye showed decreased leakage and fewer punctate lesions on fluorescein angiography. Ocular examination remained stable other than development of ocular hypertension bilaterally, which was treated with topical hypertensive drops. Two years later, patient developed a cataract in the right eye, for which the patient underwent phacoemulsification. Three years after treatment, visual acuity remains 20/20 while imaging studies and bilateral full field electroretinogram remained normal.Conclusion Intravitreal steroids can be considered as treatment in VKH in situations where systemic corticosteroids are contraindicated, such as patients with a history of poorly controlled diabetes. Complications of local steroids need to be carefully considered, even after a single injection. In some patients short-term treatment of VKH with local corticosteroid may result in long-term visual stability.

Intravitreal Triamcinolone Acetonide for Choroidal Granuloma in Sarcoidosis

2005 ◽  
Vol 139 (6) ◽  
pp. 1116-1118 ◽  
Author(s):  
Wai-Man Chan ◽  
Etrian Lim ◽  
David T.L. Liu ◽  
Ricky W.K. Law ◽  
Dennis S.C. Lam
Keyword(s):  
Triamcinolone Acetonide ◽  
Intravitreal Triamcinolone ◽  
Intravitreal Triamcinolone Acetonide ◽  
Choroidal Granuloma

scholarly journals Dramatic Resolution of Recalcitrant Cystoid Macular Edema after Concurrent Intravitreal Injection of Bevacizumab and Triamcinolone

2020 ◽  
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Cystoid Macular Edema ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Intravitreal Triamcinolone ◽  
Concurrent Treatment ◽  
Intravitreal Triamcinolone Acetonide ◽  
Anti Vegf

Background: Cystoid macular edema (CME), a common complication of branch retinal vein occlusion (BRVO), is associated with a significant vision loss. Anti-vascular endothelial growth factor (anti-VEGF) therapy is the gold standard of treatment, while grid macular photocoagulation has also been used as an adjuvant in patients with CME secondary to BRVO. More recent efforts were successful by the use of intravitreal triamcinolone acetonide. We proposed a concurrent use of intravitreal triamcinolone acetonide and intravitreal bevacizumab in the treatment of CME secondary to BRVO. Case presentation: We described an 82-year-old female with a BRVO in the right eye who developed associated CME. Repeated injections of intravitreal bevacizumab and modified grid macular laser treatment were ineffective. A concurrent treatment with intravitreal bevacizumab and triamcinolone acetonide resulted in complete and dramatic resolution of CME with a favorable visual outcome. Optical Coherence Tomography (OCT) demonstrated a significant decrease in central subfield thickness (CST) from 764μm to 253μm, without any post-procedure complications or recurrence of macular edema with complete recovery of visual acuity at 6-month follow-up. Conclusion: Early concurrent treatment with intravitreal anti-VEGF therapy (e.g. intravitreal bevacizumab) and intravitreal triamcinolone acetonide is likely to be more effective than intravitreal anti-VEGF agents alone or grid macular photocoagulation in the management of CME associated with BRVO.

scholarly journals Dramatic Resolution of Recalcitrant Cystoid Macular Edema after Concurrent Intravitreal Injection of Bevacizumab and Triamcinolone

2020 ◽  
Vol 9 (3) ◽  
pp. 159-163
Author(s):  
Kakarla V. Chalam ◽  
Suzie Gasparian ◽  
Moises Enghelberg
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Cystoid Macular Edema ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Intravitreal Triamcinolone ◽  
Concurrent Treatment ◽  
Intravitreal Triamcinolone Acetonide ◽  
Anti Vegf

Background: Cystoid macular edema (CME), a common complication of branch retinal vein occlusion (BRVO), is associated with a significant vision loss. Anti-vascular endothelial growth factor (anti-VEGF) therapy is the gold standard of treatment, while grid macular photocoagulation has also been used as an adjuvant in patients with CME secondary to BRVO. More recent efforts were successful by the use of intravitreal triamcinolone acetonide. We proposed a concurrent use of intravitreal triamcinolone acetonide and intravitreal bevacizumab in the treatment of CME secondary to BRVO. Case presentation: We described an 82-year-old female with a BRVO in the right eye who developed associated CME. Repeated injections of intravitreal bevacizumab and modified grid macular laser treatment were ineffective. A concurrent treatment with intravitreal bevacizumab and triamcinolone acetonide resulted in complete and dramatic resolution of CME with a favorable visual outcome. Optical Coherence Tomography (OCT) demonstrated a significant decrease in central subfield thickness (CST) from 764μm to 253μm, without any post-procedure complications or recurrence of macular edema with complete recovery of visual acuity at 6-month follow-up. Conclusion: Early concurrent treatment with intravitreal anti-VEGF therapy (e.g. intravitreal bevacizumab) and intravitreal triamcinolone acetonide is likely to be more effective than intravitreal anti-VEGF agents alone or grid macular photocoagulation in the management of CME associated with BRVO.

scholarly journals Bilateral Severe Sterile Inflammation with Hypopyon after Simultaneous Intravitreal Triamcinolone Acetonide and Aflibercept Injection in a Patient with Bilateral Marked Rubeosis Associated with Ocular Ischemic Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Ceren Durmaz Engin ◽  
Ziya Ayhan ◽  
Süleyman Men ◽  
Aylin Yaman ◽  
A. Osman Saatci
Keyword(s):  
Cataract Surgery ◽  
Triamcinolone Acetonide ◽  
Anterior Segment ◽  
Visual Outcome ◽  
Sterile Inflammation ◽  
Prednisolone Acetate ◽  
Intravitreal Triamcinolone ◽  
Ocular Ischemic Syndrome ◽  
The Right ◽  
Ischemic Syndrome

We report the clinical course of a diabetic patient with bilateral cataract and rubeosis in association with ocular ischemic syndrome and initially treated him with simultaneous intravitreal 2 mg aflibercept and 2 mg triamcinolone acetonide injection at the same setting prior to planned cataract surgery and further photocoagulation. However, sterile anterior segment inflammation characterized by hypopyon occurred four days apart in OU. Right eye developed the sterile inflammation at the third postinjection day and the left eye developed the sterile inflammation at the seventh postinjection day (two days after the uneventful cataract surgery with intraocular lens implantation) without any pain or significant redness. Vitreous biopsy taken during the right phacovitrectomy was negative for any microbial contamination. Both eyes were treated successfully with intensive topical prednisolone acetate with a relatively good visual outcome. It is likely that underlying ocular ischemic syndrome might have facilitated the formation of sterile inflammation as blood-aqueous barrier disruption and flare have already been present.

scholarly journals Choroidal Tuberculoma in a Healthy Immunocompetent Patient

2021 ◽  
Vol 13 (2) ◽  
pp. 202-206
Author(s):  
Hara Maya Gurung ◽  
Krishna Gurung ◽  
Anju Gurung ◽  
Indraman Maharjan ◽  
Eliya Shrestha ◽  
...  
Keyword(s):  
Rare Event ◽  
Immunocompetent Patient ◽  
Mantoux Test ◽  
Diagnostic Dilemma ◽  
Ocular Tuberculosis ◽  
Systemic Involvement ◽  
Chief Complaints ◽  
Laboratory Investigations ◽  
Choroidal Tuberculoma ◽  
Chorioretinal Scar

Introduction: Ocular tuberculosis as choroidal tuberculoma is a rare event. It creates a clinical diagnostic dilemma when there is no systemic involvement.  Case: A 22-year-old man  presented with the chief complaints of discomfort and blurring of vision of right eye for one week. On fundus examination under mydriatics of his right eye, a solitary mass which measured approximately 2DD (Disc Diameter) was appreciated at the superotemporal quadrant with the surrounding localized retinal detachment. Choroidal tuberculoma was suspected by a positive Mantoux test. Physician consultation and laboratory investigations ruled out the pulmonary and systemic manifestation of tuberculosis and other aetiology. Anti-tubercular treatment was started and this led to the improvement of vision and shrinkage of the choroidal mass into a flat chorioretinal scar at 3 months of anti-tubercular treatment .  Conclusion: Solitary choroidal tuberculoma though rare, can occur in a healthy, immunocompetent patient.

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