P 690Amelanotic choroidal tumor as a manifestation of tuberculosis
P. Frank, K.-M. Kreusel, L. Krause
Background: Amelanotic choroidal tumors often present diagnostic problems. We report a choroidal tuberculoma as a rare differential diagnosis.
Case: A 28-year-old turkish man presented with an acute loss of vision of his left eye. He showed an amelanotic double-peaked choroidal tumor that was surrounded by a detachment of the retinal pigment epithelium (RPE) including the macula. The visual acuity was 0.1.
The patient had a triple tuberculostatic therapy due to an abdominal lymph node tuberculosis with miliarisation for 3 months. During this drug therapy he developed pulmonary caverns and a choroidal tumor that was 8.5 x 8.0 mm in base and 3.0 mm in prominence. Fluorescein angiography did not show any tumor vessels.
Continuing the tuberculostatic drug therapy the tumor and the detachment of the RPE regressed and visual acuity increased accordingly. After one year a choroidal scar remained and visual acuity was 1.0 again.
Conclusion: Tuberculoma should be considered in case of an amelanotic choroidal tumor. A current tuberculostatic drug therapy does not exclude this diagnosis.
Augenklinik, Univ.-Klinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin