FP636 : Intravitreal Steroids for ‘Tubercular Choroidal Granuloma

Dr. Kushal Umeshbhai Agrawal, A16914, Dr. Jay Kumar Chhablani, Dr. Mudit Tyagi, Dr. Chintan Dedhia

35 yr female presented with OD BCVA 20/50, choroidal lesion around 3 DD, mantoux test- 22.5 mm, chest x-ray with b/l hilar prominence. ATT and oral steroids started but not improved upto 6 weeks. Intravitreal Triamcinolone 2 mg/0.05 ml and Inj. Streptomycin 750 mg/day i.m. for 2 months were injected. Rapid regression within 4 weeks and BCVA 20/30 noted. Oral steroids rapidly tapered and ATT continued as per protocol.

23 yr female presented with BCVA in OS 20/796, AC reaction+3, vitreous +3 cells, choroidal lesion of 2 DD near to fovea and mantoux-52mm. ATT started and intravitreal dexamethasone 0.4 mg/0.1 ml, 2 injections at 1 week interval f’by oral steroids started. At 3 weeks follow up residual scarring and BVCA 20/50 noted. Patient advised to continue ATT for 9 months and oral steroids tapered rapidly.

Intravitreal steroids along with ATT, besides avoiding systemic side effects of long term oral steroids, can help in rapid regression of macular threatening lesion.

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