Clinical manifestations and outcome of tuberculous sclerokeratitis

Shoughy, Samir S.; Jaroudi, Mahmoud O; Tabbara, Khalid F.

doi:10.1136/bjophthalmol-2015-307599

Cited by 12 publications

(5 citation statements)

References 19 publications

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“…Though tuberculous keratoscleritis has been known as a common differential in endemic countries, it has been often noted as scleral abscess and necrosis and not been observed as isolated corneal endothelial opacity. [ 7 20 21 ]…”

Section: Discussionmentioning

confidence: 99%

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Semilunar sign of cornea: A multimodal analysis of the posterior corneal opacity in non-infectious anterior scleritis

Kumar

Agarwal

Chandrasekar

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To analyze the morphological outcomes of the posterior corneal opacity or “semilunar sign” in noninfectious anterior scleritis using multimodal imaging. Methods: This was a prospective observational case series. Patients with anterior scleritis from January 2018 to January 2019 were included. Clinical and demographic data were collected. Posterior cornea was visualized using the digital slit lamp photography (Elite, mega digital vision), spectral domain optical coherence tomography (MS39), and specular count analyzer (EM-3000). “Semilunar sign” was defined by the (1) presence of posterior corneal opacity, (2) concave semilunar pattern, (3) absence of blood vessels, and (4) normal anterior cornea. Incidence, clinical characteristics and significance, correlation with Mantoux sensitivity, and role of multimodal valuation were assessed. Results: Overall 76 eyes of 72 patients were recruited with anterior scleritis. Fifteen eyes of 11 patients (15.3%) presented with semilunar sign. The scleritis was both nonnecrotizing ( n = 8) and necrotizing ( n = 7). The semilunar configuration appeared as isolated ( n = 9) and continuous lesion ( n = 6). The extent was directly related to the scleral disease extent ( P = 0.002). The mean thickness measured 212.5 ± 129.3 mm. The mean central endothelial cell density (ECD) was 2540.8 ± 351.7 cells/mm 2 , which was significantly higher than the involved peripheral cornea ( P = 0.05). The mean surface area of the semilunar sign was 7.7 ± 5.2 mm 2 . There was no significant correlation between the opacity thickness and the best-corrected visual acuity ( P = 0.895, r = −0.39), ECD ( P = 0.52, r = −0.188), and Mantoux ( P = 0.696, r =− 0.142) Conclusion: Corneal semilunar sign of scleritis affected the peripheral cornea and caused no functional abnormality in early presentation. Multimodal analysis can aid in clinical assessment and severity.

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Section: Discussionmentioning

confidence: 99%

“…The common morphological changes on the cornea induced by anterior scleritis are astigmatism, sclerokeratitis, limbitis, and peripheral ulcerative keratitis (PUK). [ 6 7 8 ] In 1976, Watson et al . [ 9 ] described about 29% of anterior scleritis causing corneal changes predominantly involving the anterior and the stromal layers of cornea.…”

mentioning

confidence: 99%

Semilunar sign of cornea: A multimodal analysis of the posterior corneal opacity in non-infectious anterior scleritis

Kumar

Agarwal

Chandrasekar

et al. 2022

Indian Journal of Ophthalmology

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“…A study by Wroblewski suggested that longstanding tuberculous ocular infections can produce corneoscleral perforations [7]. Shoughy et al treated all the 8 patients having scleritis with a minimum of 6 months of antitubercular drugs without concomitant use of corticosteroid and the complete resolution was seen [8].…”

Section: Discussion:-mentioning

confidence: 99%

Case Report: Tuberculous Scleritis a Challenging Diagnostic

Ouail¹,

Soukaina²,

Bennis³

et al. 2022

IJAR

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Scleritis is a severe painful inflammatory process localized in the sclera. Scleritis may be the revealer of many systemic diseases so that it is important to exclude multisystem disease. We present a case of non-necrotizing antero-posterior scleritis revealing a systemic tuberculosis which is an uncommon manifestation of tuberculosis. Diagnosing and managing the disease can be difficult. However, a good anamnesis, a careful clinical evaluation, an adequate interpretation of the investigations and an appropriate management allow a good prognosis.

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“…[3,8] Intraocular findings suggestive for the diagnosis of ocular sarcoidosis include conjunctival nodules, keratic precipitates, episcleritis, iris nodules, peripheral anterior synechiae, vitreous opacities, choroidal granulomas, retinal vasculitis, and optic disc nodules. [8][9][10] The choroid consists of a network of capillaries and larger choroidal vessels. The choroid, which is the most vascular structure of the eye, is affected by many systemic diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Uveitis, the sight threatening complication, can be diagnosed up to 20% to 30% of patients during the course of the disease [3,8] . Intraocular findings suggestive for the diagnosis of ocular sarcoidosis include conjunctival nodules, keratic precipitates, episcleritis, iris nodules, peripheral anterior synechiae, vitreous opacities, choroidal granulomas, retinal vasculitis, and optic disc nodules [8–10] …”

Section: Introductionmentioning

confidence: 99%

Choroidal vascularity index and thickness in sarcoidosis

et al. 2022

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Sarcoidosis is a multisystem granulomatous disease which is observed worldwide. Sarcoidosis is one of the common causes of ocular inflammation. The choroidal vascularity index, defined as the ratio of the luminal area to the total choroidal area, is used as one of the biomarkers for assessing the choroid vascular state. We aimed to compare choroidal vascularity index and thickness measurements between sarcoidosis patients and healthy controls.Thirty-one patients with sarcoidosis and 31 age-gender matched healthy participants were recruited in this cross-sectional and comparative study. Choroidal vascularity index was defined as the ratio of luminal area to total choroidal area after binarization on optical coherence tomography images. Anterior segment examinations included central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle. Spectral-domain optical coherence tomography was used to measure peripapillary retinal nerve fiber layer thickness, choroidal thickness, and retinal vessel caliber.The mean choroidal vascularity index value was 61.6% in sarcoidosis patients and 62.4% in healthy controls (P = .69). The choroidal vascularity index and thickness were significantly correlated in both sarcoidosis (r = 0.41, P = .026) and control groups (r = 0.51, P = .006). Both the sarcoidosis and control groups had similar measured values for central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle (P > .05). Mean retinal nerve fiber layer, retinal arteriole and venule caliber, and choroidal thickness measurements did not differ significantly between the groups (P > .05).Sarcoidosis patients in quiescent period have similar choroidal vascularity index and thickness with healthy controls.

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Clinical manifestations and outcome of tuberculous sclerokeratitis

Abstract: Antituberculous medications can lead to complete resolution of the sclerokeratitis without concomitant use of steroids, or other anti-inflammatory agents.

Cited by 12 publications

References 19 publications

Semilunar sign of cornea: A multimodal analysis of the posterior corneal opacity in non-infectious anterior scleritis

Semilunar sign of cornea: A multimodal analysis of the posterior corneal opacity in non-infectious anterior scleritis

Case Report: Tuberculous Scleritis a Challenging Diagnostic

Choroidal vascularity index and thickness in sarcoidosis

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