Title: Ocular tuberculosis without detectable systemic infection

Sarvananthan, N.; Deane, J; Thean, Li Jun; Wiselka, Martin; Goulstine, DB; Bibby, K

doi:10.1016/s0163-4453(98)80114-x

Cited by 31 publications

(48 citation statements)

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“…The clinical manifestations of tuberculous uveitis include acute anterior uveitis, chronic granulomatous anterior uveitis which may be associated with iris or angle granulomas, mutton-fat keratic precipitates and posterior synechiae, intermediate uveitis, vitritis, macular edema, retinal vasculitis, neuroretinitis, solitary or multiple choroidal tubercles, mutifocal choroiditis, choroidal granuloma, subretinal abscess, endophthalmitis, and panophthalmitis [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. In nearly all reported cases, the diagnosis of tuberculous uveitis was only presumptive based on clinical findings consistent with TB with no other cause of uveitis suggested by history, symptoms, or ancillary testing, strongly positive tuberculin skin testing, and response to anti-tuberculous therapy with absence of recurrences [1, 4-7, 10, 12].…”

Section: Introductionmentioning

confidence: 99%

Anti-tuberculous therapy combined with systemic corticosteroids improves retinal sensitivity in patients with active presumed tuberculous choroiditis

El‐Asrar

Al-Mezaine

2010

Int Ophthalmol

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To investigate the efficacy of anti-tuberculous therapy and systemic corticosteroids in patients suffering from active presumed tuberculous choroiditis by the assessment of central retinal sensitivity and fixation characteristics. Six patients (six eyes) with active presumed tuberculous choroiditis were treated with anti-tuberculous therapy and systemic corticosteroids. Mean central retinal sensitivities and fixation stability and location were investigated with MP-1 microperimetry before and after treatment. After a mean follow-up of 11.33 ± 7.53 months (range 6-24 months), all eyes showed resolution of inflammation, with no recurrences, associated with a significant improvement in visual acuity (P = 0.003). At the baseline, mean central retinal sensitivities were 2.03 ± 2.46 dB (range 0.0-6.6 dB). Fixation was stable and predominantly central in three eyes, and unstable and predominantly eccentric in three eyes. After treatment at a mean of 9.33 ± 6.56 months (range 4-20 months), mean central retinal sensitivities improved to 9.65 ± 5.35 dB (range 2.4-15.2 dB) (P = 0.004) and fixation became predominantly central and stable in all eyes. Anti-tuberculous therapy combined with systemic corticosteroids improves central retinal sensitivity and fixation characteristics in patients with presumed tuberculous choroiditis.

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Section: Introductionmentioning

confidence: 99%

Anti-tuberculous therapy combined with systemic corticosteroids improves retinal sensitivity in patients with active presumed tuberculous choroiditis

El‐Asrar

Al-Mezaine

2010

Int Ophthalmol

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“…Of these fi ve patients, four had choroidal tuberculomas and one had a vitritis/ retinitis. In the absence of chest pathology as determined by normal radiography, a conclusive diagnosis was based on Mantoux testing, PCR of the aqueous fl uid, or histopathology of the enucleated globe [ 43 ] .…”

Section: Isolated Ocular Tuberculosismentioning

confidence: 99%

Retinal and Choroidal Manifestations of Tuberculosis

Mehta

Banker²,

Chauhan³

2012

Retinal and Choroidal Manifestations of Selected Systemic Diseases

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Ocular tuberculosis has been recognized from the nineteenth century onward due to the work of Gueneau de Mussy, Jaeger, Fraenkel, and Bouchut. Ocular tuberculosis had a high prevalence worldwide in the twentieth century, but this prevalence has reduced signi fi cantly in the western hemisphere, a decline that has paralleled the decline of tuberculosis as a common systemic infection. In recent times, the prevalence varies from 18% (Spain) to 1.39% (India). The advent of the human immunode fi ciency virus (HIV) epidemic has led to an increase in the prevalence of ocular tuberculosis to up to 23.5%. Manifestations vary depending upon the ocular tissue involved. The manifestations can either be due to direct tissue infection or be hypersensitivity reactions. Rare manifestations include the eyelids (lupus vulgaris), the conjunctiva (conjunctivitis), cornea (ulcers and phlyctenulosis), and the sclera (scleritis). The most common manifestations include uveal involvement in the form of tubercles, tuberculomas, and serpiginous-like choroiditis. Other manifestations include orbital apex syndrome and lesions associated with neurotuberculosis (disc edema and sixth nerve palsies). The diagnostic workup of patients with suspected ocular tuberculosis has both systemic and ocular components. The systemic investigations include (1) radiography: (a) chest X-rays and computed tomography of the chest and (b) abdominal CT scan or ultrasonography; (2) Mantoux testing; and (3) interferon-g (gamma) release assays (IGRA). Ocular investigations of ocular fl uids or tissue biopsies include (1) microscopy, (2) culture, and (3) PCR (polymerase chain reaction) techniques. The treatment includes the use of topical, periocular, or systemic corticosteroids with a four-drug regimen of antitubercular therapy.

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“…43,44 Nekrotizan granülomlar vücudun di¤er bölgelerinde TB bulgusu olmaks›z›n izole olarak gözde meydana gelebilir. 45 Abseler likefaksiyon nekrozuna ba¤l› olarak daha sar› renkte olup üzerlerinde hemoraji gözlenebilmektedir. Bu lezyonlarda retinal anjiyomatöz proliferasyon geliflimi de rapor edilmifltir.…”

Section: Subretinal Abseunclassified

Oküler Tüberküloz I: Epidemiyoloji, Patogenez ve Klinik Özellikler

Onal¹,

Tutkun²

2011

Tjo

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ÖzetDünya Sa¤l›k Örgütü tüberküloz (TB) enfeksiyonunu morbidite ve mortalitenin en s›k nedeni olmas› sebebi ile global bir acil olarak ilan etmifltir. TB aside dayan›kl› bir basil olan Mycobacterium tuberculosis'in yol açt›¤› bir enfeksiyon olup genellikle akci¤er dokusunu etkiler [pulmoner TB (PTB)]. Ancak vücudun di¤er organ ve sistemlerinde de hastal›¤a yol açabilmektedir [Ekstrapulmoner TB (EPTB)]. PTB olan hastalar›n %1,4'ünde oküler bulgular›n geliflece¤i tahmin edilmektedir, buna karfl›n oküler TB olan hastalar›n ço¤unda PTB saptanamamaktad›r. Oküler mikobakterium tüberkülozis enfeksiyonu PTB veya EPTB'nin hematojen yay›l›m›n›n sonucudur. Semptomatik hastal›k birincil enfeksiyondan ziyade genellikle oküler dokuda canl›l›¤›n› sürdürmüfl olan sessiz lezyonlar›n reaktivasyonu yolu ile gerçekleflir. Ayr›ca immunarac›l›kl› oküler TB uzak bir odakta (örne¤in akci¤er) yer alan mikobakterium tüberkülozis antijenlerine karfl› afl›r› duyarl›l›k nedeni ile meydana gelebilir. Bu afl›r› duyarl›l›k bakteri gözde bulunmad›¤› halde inflamasyon ile neticelenir. TB'a ba¤l› intraoküler inflamasyon (üveit) prezentasyonlar› içinde en s›k olarak gözleneni arka üveit olup bunu s›ras› ile ön üveit, panüveit ve intermediyer üveit takip etmektedir. ‹ntraoküler TB tan›s› için standardize edilmifl tan›sal kriterlerin olmamas› nedeni ile tan› ve tedavi konusunda zorluklar bulunmaktad›r. Son dönemlerde saflaflt›r›lm›fl protein türevi (PPD) deri testi, interferon gama sal›n›m analizleri, toraks›n bilgisayarl› tomografisi ve polimeraz zincir reaksiyonu ile ilgili yap›lm›fl çal›flmalar oküler TB tan›s›n›n konulmas›nda yeni yaklafl›mlar›n do¤mas›na neden olmufltur. Bu derleme serisi, güncel literatür ›fl›¤›nda klinik özellikler, tan›sal yaklafl›mlar, tan›sal kriterler ve tedavi üzerinde yo¤unlaflmaktad›r. (Turk J Ophthalmol 2011; 41: 171-81) Anahtar Kelimeler: Tüberküloz, göz tutulumu, üveit, tan›, tedavi SummaryThe World Health Organization has declared tuberculosis (TB) to be a global emergency, as it remains the most common single cause of morbidity and mortality worldwide. TB is caused by the acid-fast bacillus Mycobacterium tuberculosis and primarily affects the lungs [pulmonary TB (PTB)]. It can also affect any other part of the body [extrapulmonary TB (EPTB)]. It is estimated that 1.4% of patients with PTB will eventually develop ocular disease; however, in the majority of cases of ocular TB, PTB may not be documented. Ocular TB infection is usually a result of hematogenous spread during PTB or EPTB. Symptomatic disease most commonly develops after reactivation of dormant foci in the ocular tissue rather than being the manifestation of the initial infection. Immune-mediated ocular TB can occur due to hypersensitivity to M. tuberculosis antigens from a distant focus (such as lungs), despite the absence of the bacterium in the eye. The most common clinical presentation of intraocular inflammation (uveitis) due to TB appears to be posterior uveitis, followed by anterior uveitis, panuveitis and intermediate uveitis. The absence of unif...

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Title: Ocular tuberculosis without detectable systemic infection

Cited by 31 publications

References 0 publications

Anti-tuberculous therapy combined with systemic corticosteroids improves retinal sensitivity in patients with active presumed tuberculous choroiditis

Anti-tuberculous therapy combined with systemic corticosteroids improves retinal sensitivity in patients with active presumed tuberculous choroiditis

Retinal and Choroidal Manifestations of Tuberculosis

Oküler Tüberküloz I: Epidemiyoloji, Patogenez ve Klinik Özellikler

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