Fundus findings in a series of patients with extrapulmonary tuberculosis in Thailand

Jirawison, Choeng; Liu, Yingna; Surasit, Karjbundid; Maningding, Ernest; Kamphaengkham, Siripim; Ausayakhun, Somsanguan; Heiden, David; Margolis, Todd P.; Gonzales, John A.; Acharya, Nisha R.; Keenan, Jeremy D.

doi:10.1136/bjophthalmol-2016-310105

Cited by 1 publication

(1 citation statement)

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“…In both series, choroiditis was the most common clinical presentation of OTB, and retinal vasculitis was rarely [28], or not seen [29]. The prevalence of OTB was slightly higher (~10%) when only patients with EPTB were analyzed [30]. Conversely, in patients with OTB, a recent multi-centric study found that 76.7% (604/787) did not have any past history of PTB/EPTB.…”

Section: Ocular Tb As a Form Of Extrapulmonary Tb: Host And Bacterial Factorsmentioning

confidence: 83%

Pathogenesis of ocular tuberculosis: New observations and future directions

2020

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Ocular tuberculosis (OTB) encompasses all forms of intra-and extra-ocular inflammation associated with Mycobacterium tuberculosis (Mtb) infection. However, the organism is rarely found in ocular fluid samples of diseased eyes, rendering the pathomechanisms of the disease unclear. This confounds clinical decision-making in diagnosis and treatment of OTB.Here, we critically review existing human and animal data related to ocular inflammation and TB pathogenesis to unravel likely pathomechanisms of OTB. Broadly there appear to be two fundamental mechanisms that may underlie the development of TB-associated ocular inflammation: a. inflammatory response to live/ replicating Mtb in the eye, and b. immune mediated ocular inflammation induced by non-viable Mtb or its components in the eye. This distinction is significant as in direct Mtb-driven mechanisms, diagnosis and treatment would be aimed at detection of Mtb-infection and its elimination; while indirect mechanisms would primarily require anti-inflammatory therapy with adjunctive anti-TB therapy. Further, we discuss how that most clinical phenotypes of OTB likely represent a combination of both mechanisms, with one being predominant than the other.

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Section: Ocular Tb As a Form Of Extrapulmonary Tb: Host And Bacterial Factorsmentioning

confidence: 83%