title: Bilateral choroidal tuberculoma in miliary tuberculosis - report of a case.
abstract: BACKGROUND
  A choroidal mass or granuloma is a feature of ocular tuberculosis (TB). Tubercles can arise in the early stages of progression of TB and indicate hematogenous dissemination before the development of symptomatic disease. Tubercular subretinal granuloma is responsive to treatment with anti-tuberculosis therapy, and prompt treatment helps resolve the lesion completely.
  
  
  RESULTS
  We report a case of a solitary large active choroidal tuberculoma in one eye and multiple healed tubercles in the other. The patient was an immunocompetent girl with splenic and miliary TB and had a relatively asymptomatic systemic status. Aqueous humor analysis by polymerase chain reaction (PCR) and real-time PCR (RT-PCR) was negative for the Mycobacterium tuberculosis genome. Based on clinical history and investigations, treatment with four-drug regimen of anti-tubercular treatment with concomitant corticosteroids was started, and total healing of the lesion occurred in 3 months.
  
  
  CONCLUSIONS
  This case highlights the fact that in some patients, analysis of the aqueous may not provide any clue to the confirmation of an active tubercular choroidal granuloma and an association between splenic tuberculosis and choroidal tubercles has never been reported in the past.
authors: Sri Ramachandra University, Porur, Chennai, 600166 India.
authors: Radha
authors: R
authors: Annamalai
authors: Uveitis & Ocular Pathology Department, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai, 600006 India.
authors: Jyotirmay
authors: J
authors: Biswas
keywords: Angiography; Aqueous humor; Choroidal tuberculoma; Mycobacterium tuberculosis; Real-time polymerase chain reaction