Optical coherence tomography in presumed tuberculous choroidal granulomas
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Choroidal osteoma is a rare benign tumor of unknown etiology, commonly found in young asymptomatic females in their second or third decade of life. It typically appears as an orange-yellow to yellow-white lesion in juxtapapillary region which can extend over to involve macula. Lesion solely located in macular region is less common. Diagnosis is based on fundoscopic appearance and findings of ancillary tests like B scan ultrasonography, optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and computerized tomography (CT) scan. We report a case of unilateral macular choroidal osteoma in a fifteen-year-old girl with normal vision.
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A case of congenital vitreous cyst is presented. An optical coherence tomography scan has been performed, which has shown that the cyst is free floating and is multilobular. Its content was hyper-reflective.
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Purpose: To report, in vivo, on the quasi-histologic characteristics of a sarcoid choroidal granuloma as visualized by Enhanced Depth Imaging Spectral Domain Optical Coherence Tomography (EDI SD-OCT).Methods: A 49 year-old woman showing a choroidal granuloma secondary to sarcoidosis was imaged by EDI OCT.Result: On EDI SD-OCT examination, sarcoid choroidal granuloma appears as a localized hyporeflectivechoroidalthickening. Two weeks after systemic corticosteroids, the thickness of the granuloma decreased from 568 μm to 356 μm. Five months later, it reached 274 μm, and after eleven months, it decreased to 150 μm.Conclusion: EDI SD-OCT allows direct visualization of choroidal granuloma secondary to sarcoidosis and evaluation of lesion regression after treatment.
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Purpose Ocular tuberculosis has protean clinical manifestations. Because of its varied clinical presentation, multimodal imaging is very important to characterize the disease activity, presence of inflammation, determining therapeutic response, and detection of complications.Methods Narrative reviewResults In this review, various imaging modalities employed in the management of ocular tuberculosis including fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) have been reviewed. Not only do these imaging tools complement each other in providing a comprehensive assessment of the pathology, they also help in gaining valuable insights regarding the evolution of the disease.Conclusions Fundus imaging plays a vital role in the diagnosis and management of patients with posterior uveitis due to tuberculosis. Fundus imaging may have a useful role in defining clinical endpoints for ocular tuberculosis in the future.
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days) of OCT follow up.OCT analysis was performed for each cross sectional frames every 1.0 mm intervals.In the stent struts analysis, all visible stent struts were classified into 4 categories by strut position to lumen contour; Class I = no protruded strut, Class II = mild protruded strut, Class III = severe protruded strut and Class IV = completely malapposed strut (Figure).All the OCT findings were compared between short term group and very long term group.Results: In the OCT analysis, mean lumen diameter was 2.9 mm and 3.0 mm of short term group and very long term group respectively (p=0.12).Mean stent diameter was 2.9 mm and 3.2 mm of short term group and very long term group respectively (p=0.70).Total analyzed stented segment was 21.0 mm and 27.8 mm of short term group and very long term group respectively (p=0.062).In the stent struts analysis, 3231 and 4101 struts of short term group and long term group were identified.Malapposed stent struts were observed in 2.9% and 3.6% of short term group and very long term group respectively (p=0.74).In the stent strut classification, very long term group had significantly higher rate of Class III and IV (worse strut positions) than short term group (p=0.033).Figure 1 Conclusion(s): In this study, the OCT follow up showed that malapposed stent struts were still in the stented segment even in very long time after SES implantation, and Class III and IV of stent struts were significantly more often in very long term group than short term group.
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Choroidal osteoma is a rare, benign, ossifying intraocular tumor of unknown etiology. While patients with choroidal osteoma usually show distinct large yellowish subretinal lesions, some could have small lesions, making the differential diagnosis difficult. We experienced 2 cases of small symptomatic unilateral osteoma approximately 1.0-mm disc diameter in size.Retrospective medical charts of 2 patients with small symptomatic unilateral osteoma were reviewed. Fundus examination, spectral domain enhanced-depth optical coherence tomography (EDI-OCT), fluorescein angiography, indocyanine green angiography, B-scan ultrasonography (USG), and X-ray computed tomography (CT) were performed.Case 1: a case of a 41-year-old male. Fundus examination revealed a yellowish-white lesion of 1.0-mm disc diameter in size. EDI-OCT of the lesion shows sub-RPE elevation. B-scan USG was not definite for diagnosis. Thin-slice (2 mm) CT scan revealed a choroidal osteoma. Case 2: a case of a 70-year-old male. Fundus examination revealed a yellowish-white lesion of 0.9-mm disc diameter. EDI-OCT showed sub-RPE elevation without serous retinal detachment and horizontal lamellar-like structure within the lesion. B-scan USG suggested acoustic shadowing, but it was unclear. The thin-slice CT scan confirmed bony tissue at the lesion.We report 2 cases of small choroidal osteoma. Diagnosis of small yellowish subretinal lesions is sometimes difficult. Characteristic findings with EDI-OCT may sometimes suggest this disease, and thin-slice CT could help to diagnose choroidal osteoma.
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