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Year : 2018  |  Volume : 66  |  Issue : 2  |  Page : 301

Management challenge: Optic disc granuloma in pulmonary tuberculosis

Neuro-Ophthalmology, Aravind Eye Care, Puducherry, India

Date of Web Publication30-Jan-2018

Correspondence Address:
Dr. Priya Sivakumar
Aravind Eye Care, Thavalakuppam, Puducherry - 605 007
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_571_17

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How to cite this article:
Sivakumar P, Vedachalam R, Devy N. Management challenge: Optic disc granuloma in pulmonary tuberculosis. Indian J Ophthalmol 2018;66:301

How to cite this URL:
Sivakumar P, Vedachalam R, Devy N. Management challenge: Optic disc granuloma in pulmonary tuberculosis. Indian J Ophthalmol [serial online] 2018 [cited 2020 Aug 4];66:301. Available from: http://www.ijo.in/text.asp?2018/66/2/301/224085

A 45-year-old gentleman presented with chronic cough and defective vision in his right eye. The best-corrected vision was 5/60, and fundus examination revealed optic disc granuloma with surrounding retinal edema [Figure 1]a. The chest X-ray showed a cavitary lesion in the right upper lobe [Figure 1]b and sputum culture was positive for tuberculosis. The patient was started on standard 4-drug antitubercular therapy along with oral prednisolone 1 mg/kg in tapering dose in view of his ocular condition. On follow-up, disc granuloma resolved [Figure 1]c and [Figure 1]d and visual acuity improved to 6/18. Ocular damage occurs as the result of infection as well as reactive tissue inflammation. Treatment has to address both arms.[1],[2],[3],[4]
Figure 1: (a) Ocular fundus photo showing optic nerve head granuloma (arrowhead), peripapillary retinal edema (asterisx), and engorged retinal veins (arrow). (b) Chest X-ray showing cavitary lesion (arrowhead) in the right upper lobe. (c) Resolving optic disc granuloma (arrowhead) and peripheral chorioretinal lesion (arrow) 1-month postantitubercular treatment. (d) Complete resolution of granuloma (arrowhead) with peripheral chorioretinal scarring (arrow) 3-month postantitubercular treatment

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Prasad K, Singh MB. Corticosteroids for managing tuberculous meningitis. Cochrane Database Syst Rev 2008;23:CD002244.  Back to cited text no. 1
Ntsekhe M, Wiysonge C, Volmink JA, Commerford PJ, Mayosi BM. Adjuvant corticosteroids for tuberculous pericarditis: Promising, but not proven. QJM 2003;96:593-9.  Back to cited text no. 2
González-Granado LI. Steroids: A promising drug for abdominal tuberculosis? J Lab Physicians 2010;2:49.  Back to cited text no. 3
Esen E, Sızmaz S, Kunt Z, Demircan N. Paradoxical worsening of tubercular serpiginous-like choroiditis after initiation of antitubercular therapy. Turk J Ophthalmol 2016;46:186-9.  Back to cited text no. 4


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