ocular tuberculosis

Topics: Tuberculosis, Ophthalmology, Tuberculosis treatment Pages: 4 (861 words) Published: October 10, 2014
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.

Case 1
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.

Case 2
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...

References: 1. Chen FK, White A, Harney BA. Systemic tuberculosis presenting with bilateral visual loss. Br J Ophthalmol 2009
2. Sheu SJ, et al. Ocular manifestations of tuberculosis. Ophthalmology 2001; 108(9): 1580-1585.
3. Bodaghi, BMDP. LeHoang PMDP. Ocular tuberculosis. Curr Opin Ophthalmol 2000; 11(6): 443-448.
4. Bowyer JD, et al. Choroidal tuberculosis diagnosed by polymerase chain reaction: a clinicopathologic case report historical image. Ophthalmology 1999; 106(2): 290-294.
5. Saini JS, Mukherjee AK,Nadkarni N. Primary tuberculosis of the retina. Br J Ophthalmol 1986; 70(7): 533-535.
6. Gupta A, Gupta V. Tubercular posterior uveitis. Int Ophthalmol Clin 2005; 45(2): 71-88.
7. Thompson MJ, Albert DM. Ocular tuberculosis. Arch Ophthalmol 2005; 123(6): 844-849.
8. O 'Hearn TM, et al. Presumed ocular tuberculosis presenting as a branch retinal vein occlusion in the absence of retinal vasculitis or uveitis. Br J Ophthalmol 2007; 91(7): 981-982.
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