Abstract:Three-dimensional SD-OCT allows a spatial visualisation and documentation of retinal elevation. It also allows a detailed visualisation of the secondary retinal pigment epithelial and intraretinal changes and is helpful in monitoring the response to medication.
“…OCT revealed attachment between the retinal pigment epithelium (RPE)-choriocapillaris layer and neurosensory retina over the granuloma (Fig. 15A), which was previously reported in the literature (67). Salman et al (68) coined this the “contact sign” and felt that this was due to inflammatory adhesions causing the neurosensory retina to stick to the RPE.…”
Ocular tuberculosis is an extrapulmonary mycobacterial infection with variable manifestations. The reported incidence of ocular involvement varies considerably, depending on the criteria used for diagnosis and the population sampled. However, tuberculosis is thought to affect the lungs in 80% of patients, with the remaining 20% being affected in other organs, such as the eye. It is imperative for physicians to consider this diagnosis in their differential, as ocular tuberculosis can present in a fashion similar to that of more common conditions causing ocular inflammation. In addition, prompt recognition of the clinical signs and symptoms leads to quicker initiation of antituberculosis therapy.
“…OCT revealed attachment between the retinal pigment epithelium (RPE)-choriocapillaris layer and neurosensory retina over the granuloma (Fig. 15A), which was previously reported in the literature (67). Salman et al (68) coined this the “contact sign” and felt that this was due to inflammatory adhesions causing the neurosensory retina to stick to the RPE.…”
Ocular tuberculosis is an extrapulmonary mycobacterial infection with variable manifestations. The reported incidence of ocular involvement varies considerably, depending on the criteria used for diagnosis and the population sampled. However, tuberculosis is thought to affect the lungs in 80% of patients, with the remaining 20% being affected in other organs, such as the eye. It is imperative for physicians to consider this diagnosis in their differential, as ocular tuberculosis can present in a fashion similar to that of more common conditions causing ocular inflammation. In addition, prompt recognition of the clinical signs and symptoms leads to quicker initiation of antituberculosis therapy.
“…The SD-OCT pattern for choroidal TB has been described previously [3,4]. Salman et al described the characteristic but not the pathognomonic features of tuberculous choroidal granulomas [3].…”
Section: Discussionmentioning
confidence: 99%
“…A definitive diagnosis of ocular TB is established by the combination of clinical ocular inflammatory signs and the demonstration of the mycobacterium M [4]. Moreover, ocular TB may occur in patients with no systemic disease.…”
The aim of this study is to report the clinical and spectral domain optical coherence tomography (SD-OCT) findings in a patient suffering from ulcerative colitis with bilateral tubercular chorioretinitis and intraretinal granuloma regressed with systemic antitubercular therapy (ATT). This study is a case report of a 33-year-old Bangladeshi male with ulcerative colitis treated with oral corticosteroids and azathioprine who was referred to our department with a diagnosis of central serous chorioretinopathy. Serological tests, the Mantoux skin test, complete ophthalmologic examination, ocular fundus photography, fundus fluorescein angiography, and SD-OCT scans were performed. The ophthalmological inflammatory pattern and serological investigations provided an early diagnosis of ocular tuberculosis. Systemic ATT led to significant improvement and resolution of the ocular inflammation. SD-OCT was a useful non-contact imaging technique in the follow-up of tubercular choroiditis. The excellent response to systemic ATT confirmed the clinical diagnosis. This is an unusual case of tubercular chorioretinitis with intraretinal granuloma and is the first such SD-OCT description reported in the ophthalmological literature.
“…In tuberculosis uveitis, the cells in the posterior vitreous were visible which was made out well only in conventional and CDI scans. Serous retinal detachment, outer retinal changes in form of disruption of IS/OS junction, proliferating retinal pigment epithelium cells [[ 21 ]] were well made out in all three scanning techniques, whereas increased choroidal thickness with hyporeflective choroidal granulomas [[ 22 ]] in cases of choroiditis [[ 22 ]] and outer choroidal border was well made out only in the EDI and CDI scans (Figure 5 ). Figure 5 Tuberculosis.…”
BackgroundUnderstanding the changes that occur in the choroid is of paramount importance in various uveitis entities. B-scan ultrasonography and indocyanine green angiography can be used to study choroid. Currently, spectral-domain optical coherence tomography is used as the standard noninvasive technique to study the choroid by enhanced depth imaging.Our aim was to study the structural visibility of the choroid using spectral-domain optical coherence tomography in the same area of interest in patients with uveitis with posterior segment manifestations using conventional, enhanced depth imaging (EDI), and combined depth imaging (CDI) techniques.ResultsFifty-eight (58) eyes of 48 patients between age group 9 and 82 years were confirmed cases of uveitis. Out of the 48 patients, 21 (43.75%) were males while 27 (56.25%) were females. Sixteen eyes (27.59%) had intermediate uveitis, 33 (56.9%) had posterior uveitis, and 9 eyes (15.51%) had panuveitis.For posterior vitreous, there was substantial agreement for all the three groups (kappa value of 0.77, 0.73, and 0.72 in groups 1, 2, and 3, respectively). For vitreo retinal interface and inner choroid, there was perfect interobserver agreement, and for outer choroid, there was substantial to almost perfect interobserver agreement (kappa value of 0.71, 0.81, and 0.86 in groups 1, 2, and 3, respectively).Chi-squared test was done to compare the three groups. The method of scanning had a significant effect on the visualization of posterior vitreous and the outer choroid (p < 0.01) and did not have an effect on the visualization of vitreoretinal interface, inner retina, outer retina, and inner choroidal layers (p > 0.05).ConclusionThe CDI technique alone might provide a good structural visibility compared to normal and EDI scanning done separately in patients with uveitis with posterior segment pathology. CDI OCT technique is thus able to visualize all posterior structures in a single image in patients with uveitis with posterior segment manifestations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12348-014-0018-8) contains supplementary material, which is available to authorized users.
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