| Presentation preference | Oral presentation |
| Title | Intravitreal aflibercept for the treatment of a large choroidal tuberculoma: a case report |
| Purpose | To report a case of a large choroidal tuberculoma, unresponsive to antitubercular therapy (ATT) and systemic corticosteroids, successfully treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections. |
| Methods | A retrospective review of records from a patient with tubercular uveitis was performed. |
| Results | An 11-year-old girl presented to ophthalmological evaluation with bilateral ocular pain and red-eye with one month duration. Her best-corrected visual acuity (BCVA) was 20/32 in the right eye (RE) and 20/63 in the left eye (LE). Biomicroscopy revealed bilateral anterior uveitis with iris nodules and fundoscopy showed dense vitritis in both eyes. A complete systemic work-up was performed, with a positive interferon-γ release assay and features suggestive of tuberculosis on chest computed tomography scans. ATT and systemic corticosteroids were started, with progressive resolution of the ocular inflammation. As vitritis cleared, a large macular choroidal tuberculoma with associated subretinal fluid was noted in LE fundoscopy and confirmed by optical coherence tomography. Since the lesion was non-responsive to conventional treatment for tubercular uveitis, intravitreal anti-VEGF injections were started as an adjuvant therapy. The child received two intravitreal injections of aflibercept, with complete regression of the choroidal tuberculoma and resolution of the subretinal fluid. At 6-months follow-up, BCVA was 20/25 in both eyes with no recurrence of the disease. |
| Conclusion | Despite seldomly described in literature, intravitreal anti-VEGF therapy may have a role in the treatment of large choroidal tuberculomas with weak response to conventional therapy. |
| Conflict of interest | No |
Authors 1
| Last name | FERREIRA |
| Initials of first name(s) | C. |
| Department | Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho |
| City | Vila Nova de Gaia |
| Country | Portugal |
Authors 2
| Last name | MARTINS |
| Initials of first name(s) | P. |
| Department | Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho |
| City | Vila Nova de Gaia |
| Country | Portugal |
Authors 3
| Last name | FONSECA |
| Initials of first name(s) | S. |
| Department | Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho |
| City | Vila Nova de Gaia |
| Country | Portugal |
