To report the clinical and multimodal imaging findings of presumed tuberculous optic nerve head (ONH) infiltration in 3 patients at a tertiary eye care center. In addition to unilateral presumed tuberculous ONH infiltration, all patients had clinical findings suggestive of tuberculous choroidal involvement which was confirmed by Indocyanine green angiography (ICGA). All patients were treated successfully with a combination of antituberculous regimen and systemic corticosteroids.
Previous reports of tuberculous ONH granuloma have been described in patients suffering from miliary TB.Our cases differ from earlier reports in that all had no active pulmonary TB, the anterior segment examination was completely normal, and vitritis was absent. It is noteworthy that the ICG demonstrated that the choroidal involvement was more extensive than what was seen clinically. Recently, ICGA has been shown to be helpful in detecting subclinical choroidal involvement that is not evident by fundus examination or fluorescein angiography in patients with Presumed intraocular tuberculosis (PIOTB).
