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Multimodal imaging of reactive retinal astrocytic vasoproliferative tumour in a case of systemic tuberculosis
  1. Sindhuja Kandasamy,
  2. Divya Agarwal and
  3. Rohan Chawla
  1. Ophthalmology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Rohan Chawla; dr.rohanrpc{at}gmail.com

Abstract

A man in his 20s presented with diminished vision in the left eye. He had a history of Pott’s spine and had been diagnosed elsewhere as having left eye tubercular granuloma in the retina. He was started on anti-tubercular therapy and high-dose oral steroids. He presented to us 1 month later. Presently fundus examination revealed a yellow to whitish mass temporal to disc with diffuse hard exudates throughout the retina. Swept-source optical coherence tomography (SSOCT) revealed a hyper-reflective mass involving the retina. SSOCT angiography and fundus fluorescein angiography revealed vascularity within the lesion. We made a diagnosis of a secondary reactive retinal astrocytic vasoproliferative tumour (VPT) and hence tapered the steroids and given intravitreal bevacizumab injection. At 6 weeks follow-up after intravitreal bevacizumab, there was some amount of resolution of hard exudates along with reduction of the vascular pattern of the lesion. The peripapillary location and development of a VPT following resolution of a presumed tubercular granuloma is rare.

  • Retina
  • Macula
  • Ophthalmology

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Footnotes

  • Contributors SK contributed to drafting the manuscript, data collection, image acquisition and critical analysis. DA contributed to data collection, analysis and revision of the manuscript. RC contributed to diagnosis, treatment of the patient, data collection, analysis and final approval of the version sent for publication. All authors approved the manuscript and take responsibility for the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.