PMC5340087_01
RE showing subretinal mass lesion. White arrows demarcating the outline of retinal detachment.
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F1
Fundus examination of the right eye showed a yellowish white subretinal mass lesion six to eight disc diameters in size, located at the superotemporal arcade, just reaching the fovea with an overlying exudative detachment (Figure 1 (Fig. 1)).
FFA shows early hyperflourescence with late pooling in serous detachment.
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F2
Fundus flourescein angiography showed an early hyperflourescence in the region of the lesion with progressive increase in hyperflourescence and pooling of the dye outlining the serous detachment by late phases (Figure 2 (Fig. 2)).
Ultrasonography shows a mass lesion of uniform echogenecity and low internal reflectivity.
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F3
Ultrasonography showed a mass lesion of uniform echogenecity with low internal reflectivity (Figure 3 (Fig. 3)).
PET scan shows enlarged lymph nodes in cervical, mediastinal, and retroperitoneal regions.
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F4
PET scan (Figure 4 (Fig. 4)) reporting was presence of multiple 18F-fluorodeoxyglucose (FDG) avid nodes (up to level IV) in cervical, mediastinal and retroperitoneal region - suggestive of an inflammatory pathology (tuberculosis) or metastases.
Showing granuloma with Langhan's giant cells and caseation necrosis
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F5
There was no evidence of neoplasia (Figure 5 (Fig. 5)).
Healing lesion two months after starting anti-tuberculous treatment
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F6
The lesion started showing healing from the edges within two weeks after starting anti-tuberculous treatment (ATT) (Figure 6 (Fig. 6) and Figure 7 (Fig. 7)).
Scarred granuloma seven months after starting anti-tuberculous treatment. Fovea is spared.
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F7
The lesion started showing healing from the edges within two weeks after starting anti-tuberculous treatment (ATT) (Figure 6 (Fig. 6) and Figure 7 (Fig. 7)).
Juxtafoveal yellowish white lesion adjacent to healed scar with retinal edema, subretinal blood, exudates and subretinal fluid. FFA and SD-OCT showed signs of active choroidal neovascular membrane at the margin of the scar.
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F8
RE. RE fundus examination showed macular edema with subretinal blood and exudates adjacent to the scar of the previous choroidal granuloma (Figure 8 (Fig. 8)).
At one-year follow-up, fundus picture showed healed, pigmented scarred lesion at fovea. OCT showed reduced thickness, scarred lesion with partial restoration of foveal contour.
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F9
The CNVM resolved after four intravitreal Bevacizumab (Avastin) injections, leaving a scar with BCVA of 6/36 (Figure 9 (Fig. 9)).