title: Photodynamic therapy as an adjunct to systemic treatment in a case with unilateral presumed vascularized choroidal tuberculous granuloma.
abstract: Intraocular tuberculosis cannot be diagnosed easily in some clinical circumstances. A 29-year-old otherwise healthy woman who was initially misdiagnosed and treated empirically with systemic steroids and sulfamethoxazole-trimethoprim for toxoplasmosis was referred to us for severe visual loss. We instituted quadruple antituberculosis treatment upon chest medicine consultation as all attempts, including consecutive intravitreal antibiotic injections, could not prevent the enlargement of lesion. Systemic antituberculosis treatment halted the fulminant course but the granuloma became vascularized. Because photodynamic therapy (PDT) has very recently been shown to reduce viable mycobacterial cells in animal experiments we performed PDT, and the vascularized tuberculous granuloma was successfully treated. PDT may have an antimycobacterial effect besides its well-known antiangiogenic effect.
authors.affiliation: Department of Ophthalmology, Dokuz Eylul University, Mustafa Kemal Sahil Bui. No. 73, Narhdere, Izmir, Turkey. osman.saatci@yahoo.com
authors.forename: Ali Osman
authors.initials: AO
authors.lastname: Saatci
authors.forename: Ozlem Barut
authors.initials: OB
authors.lastname: Selver
authors.forename: Aylin
authors.initials: A
authors.lastname: Yaman
authors.forename: Gul
authors.initials: G
authors.lastname: Arikan
authors.forename: Arzu
authors.initials: A
authors.lastname: Sayiner
authors.forename: Atilla
authors.initials: A
authors.lastname: Akkoclu
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001808:Blood Vessels / Q000473:pathology*; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D003951:Diagnostic Errors; D005260:Female; D005654:Fundus Oculi; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D010778:Photochemotherapy; D016896:Treatment Outcome; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents