VASO OCCLUSIVE CHANGES IN HIDDEN OCULAR TUBERCULOSIS
Ocular TB may affect any ocular or orbital tissue, either by an active infection or an immunologic reaction, related to delayed hypersensitivity and an aseptic reaction [1-4]. Features of ocular TB include choroiditis which is the common ocular finding while other ocular manifestation such as anterior uveitis, choroid tubercles, retinal vasculitis, vascular occlusion, dense vitritis, papilitis and phylectenulosis or interstitial keratitis may also occur[1, 2, 5-7]. Here, we report three cases of presumed ocular TB with hidden vaso-occlusive changes.
Materials and methods
A retrospective case review of 3 patients with a diagnosis of presumed ocular TB who treated with anti tuberculosis treatment trial at Eye Clinic.
A 24 year-old male, presented with left eye progressively reduced of vision, visual acuity was counting finger and his ocular examination showed presence of vitreous hemorrhage with fibrovascular tissue (Fig.1a). Vitrectomy was performed and proceeds with endolaser in view of presence of vaso-occlusive changes in the posterior pole. Mantoux test and erythrocyte sedimentation rate (ESR) were 15mm and 2mm/h respectively. Anti-TB regimen initiated and his vision improved to 20/25 with clear fundus view (Fig.1b) after completion of anti TB treatment.
A 17 year-old male, presented with right eye sudden onset painless reduced of vision. Best corrected visual acuity in the right eye was 6/60 and ocular examinations showed features of panuveitis. There was presence of KP`s, moderate anterior chamber reaction with 1mm hypopyon, moderate vitritis with vitreous condensation, hyperemic disc with multifocal choroiditis and vasculitic changes (Fig.2a). Fluorescein fundus angiography showed vaso-occlusive changes and disc neovascularization. ESR was 13mm/h however there was no reaction of Mantoux test. Other blood investigation revealed negative collagen...
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