Sudden monocular vision decrease caused by isolated choroidal tuberculoma during anti-tuberculosis treatment: a case report

Mycobacterium tuberculosis primarily causes pulmonary diseases; however, it can also affect extrapulmonary organs, including the eyes. The choroid, as the intraocular tissue with the richest blood supply, is one of the most susceptible structures to intraocular tuberculosis. Abnormal ocular symptoms that occur during systemic anti-tuberculosis treatment (ATT) can easily be misdiagnosed as drug side effects or treatment failure. Abruptly discontinuing a specific medication could lead to the recurrence of extraocular tuberculosis and irreversible vision loss. This case study focuses on a young female who exhibited an abnormal ocular reaction during systemic ATT. Owing to an incorrect assessment in the initial stages, timely and appropriate treatment could not be initiated. Isolated abnormal ocular reactions during ATT are relatively rare. To help doctors promptly and accurately assess abnormal eye conditions, we suggest that patients who are diagnosed with tuberculosis in any organ visit an ophthalmologist immediately for a comprehensive examination to establish baseline data. This approach aims to minimize the risk of adverse deterioration during treatment as much as possible.