Paradoxical growth of presumed optochiasmatic tuberculomas following medical therapy

Mary Joseph, Teena M. Mendonca, Usha Vasu, Suneetha Nithyanandam, Thomas Mathew

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


IMPORTANCE: Tuberculosis is an endemic infectious disease in developing countries. Patients receiving treatment for systemic tuberculosis may develop paradoxical growth of tuberculomas in the brain, which can lead to vision loss. OBSERVATIONS: We describe 3 patients who had paradoxical development of tuberculomas in the anterior optic pathway during treatment for tuberculosis and presented with acute vision loss. These optochiasmatic tuberculomas were not present at the initial presentation of tuberculosis and appeared on brain magnetic resonance imaging at the time of presentation with vision loss. Vision improved on instituting systemic corticosteroids in addition to antituberculous treatment. CONCLUSIONS AND RELEVANCE: As there was visual recovery after patients began receiving systemic corticosteroids and there was no worsening of the systemic condition, it is reasonable to assume that the optochiasmatic tuberculomas resulted from a paradoxical reaction. It is important to recognize this condition and initiate prompt treatment to reduce visual morbidity.

Original languageEnglish
Pages (from-to)1463-1467
Number of pages5
JournalJAMA Ophthalmology
Issue number11
Publication statusPublished - 11-2013

All Science Journal Classification (ASJC) codes

  • Ophthalmology


Dive into the research topics of 'Paradoxical growth of presumed optochiasmatic tuberculomas following medical therapy'. Together they form a unique fingerprint.

Cite this