Ocular tuberculosis: Where are we today?

Abstract

Diagnosis and management of ocular tuberculosis (OTB) poses a significant challenge. Mixed ocular tissue involvement and lack of agreement on best practice diagnostic tests together with the global variations in therapeutic management contributed to the existing uncertainties regarding the outcome of the disease. The current review aims to update recent progress on OTB. In particular, the Collaborative Ocular Tuberculosis Study (COTS) group recently standardized a nomenclature system for defining clinical phenotypes, and also proposed consensus guidelines and an algorithmic approach for management of different clinical phenotypes of OTB. Recent developments in experimental research and innovations in molecular diagnostics and imaging technology have provided a new understanding in the pathogenesis and natural history of the disease.

Differences between Mycobacterium chimaera and tuberculosis Using Ocular Multimodal Imaging: A Systematic Review

“…However, the diagnosis of ocular TB is still challenging, owing to the involvement of mixed tissues and heterogenous infections [ 24 ]. The emergence of more advanced TB diagnostic tools, such as IFN-γ release assays, radiodiagnostics, and molecular biology techniques has markedly improved the specificity of ocular TB diagnosis [ 25 ].…”

“…The fluorescent pattern for active and inactive lesions seems to be similar for both diseases. However, the shape and type of lesions, and also their distribution, differs between the two entities [ 9 , 22 , 24 ]. Contrary to the TB cases, the M. chimaera -infected cases do not present capillary nonperfusion, cystoid macular edema, or retinal vasculitis [ 7 , 9 , 10 ].…”

The diagnostic value of polymerase chain reaction for ocular tuberculosis diagnosis in relation to antitubercular therapy response: a meta-analysis

“…The true prevalence of ocular TB is hard to be determined, but it was reported between 0.2-10.5% among all uveitis cases in referral hospitals (Agrawal et al, 2020). This happens as many patients are diagnosed with presumptive ocular TB with a wide spectrum of clinical appearances and the use of corroborative evidence to find indirect evidence of TB infection or after exclusion of the other possible causes (Testi et al, 2020). However, in our previous study, TB-related uveitis might account for up to 48% of uveitis cases if interferon-gamma release assay (IGRA) positive patients were accounted for (La Distia Nora et al, 2018).…”

“…(Mochizuki et al, 2017) The application of a gold standard test to find Mtb from ocular fluid practically is difficult to obtain by culture or smear. Thus, experts agreed to start ATT based on several criteria, not merely depend on Mtb found in the ocular samples (Agarwal et al, 2019a;Agrawal et al, 2020;Testi et al, 2020). The sensitivity and specificity of PCR from ocular samples often being calculated back using the clinical diagnosis of presumptive ocular TB (Barik et al, 2018).…”

Exploring a New Era in Uveitis

“…The issue begins with a beautiful account of the history and evolution of the USI, pays tribute to the pioneers of uveitis practice in India, and then moves on to many different forms of uveitis and scleritis. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ]…”