Massive choroidal granuloma as the presenting feature of disseminated tuberculosis in immunocompetent patients

Involvement of the choroid, by direct infection or indirect immune-mediated hypersensitivity, is the commonest clinical manifestation of intraocular tuberculosis. The presentation varies from a solitary choroidal granuloma (tuberculoma) to multiple choroidal tubercles, a subretinal abscess or choroiditis. We describe two patients who presented with massive choroidal granulomas and were found to have multi-system tubercular involvement leading to the diagnosis of disseminated tuberculosis.

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