Multimodal imaging of a choroidal granuloma as a first sign of tuberculosis

•Choroidal granuloma of ocular Tuberculosis can be the first sign of Tuberculosis.•Choroidal granuloma in tuberculosis can be diagnosed with the use of OCT.•OCT-A may provide useful information about the retinal microvascular involvement in patients with choroidal tuberculoma. Choroidal granuloma is rarely seen as the first sign of tuberculosis(TB). Here we report a case of a 34-year old male with a choroidal mass which was associated with serous retinal detachment on EDI-OCT and the “contact sign” between the neurosensory retina and the retinal pigment epithelium. We analysed the macular microvascular features of tuberculoma with Optical Coherence Tomography Angiography(OCTA). After 3 months of antituberculosis treatment, we observed the shrinkage of granuloma with permanent changes of macular microvasculature in deep capillary plexus and choriocapillaris. In conclusion, OCT-A may provide useful information about the retinal microvascular involvement in patients with choroidal tuberculoma.