Shree K Kurup1, Chi-Chao Chan. 1. Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892-1857, USA.
Abstract
INTRODUCTION: Worldwide, there are approximately 8 million new cases and 3 million deaths from tuberculosis (TB) each year. TB affects the entire body and the eye. Although ocular TB is considered rare, its incidence has varied widely across time, patient populations, and geography. We report 2 patients with unique presentations of ocular TB and detail the treatment and outcome of the disease. MATERIALS AND METHODS: Two cases of ocular inflammation, one with a medical history of systemic TB and the other, with that of presumed systemic TB, were examined. Choroidal granuloma developed in one, and scleritis developed in the other. The literature on ocular TB was comprehensively reviewed. RESULTS: Both patients were diagnosed with ocular TB. The histology of the systemic TB lesions was also illustrated. They responded to aggressive anti- TB and anti-inflammatory therapies. CONCLUSIONS: The diagnosis and management of ocular TB can pose a significant challenge. Physicians and ophthalmologists must include TB among the differential diagnoses of patients with ocular inflammatory diseases and treat ocular TB with a combination of anti-TB and immunosuppressive medications as needed. Immunosuppressive medications applied in this setting must be cautioned and only prescribed by ophthalmologists who are familiar with these agents.
INTRODUCTION: Worldwide, there are approximately 8 million new cases and 3 million deaths from tuberculosis (TB) each year. TB affects the entire body and the eye. Although ocular TB is considered rare, its incidence has varied widely across time, patient populations, and geography. We report 2 patients with unique presentations of ocular TB and detail the treatment and outcome of the disease. MATERIALS AND METHODS: Two cases of ocular inflammation, one with a medical history of systemic TB and the other, with that of presumed systemic TB, were examined. Choroidal granuloma developed in one, and scleritis developed in the other. The literature on ocular TB was comprehensively reviewed. RESULTS: Both patients were diagnosed with ocular TB. The histology of the systemic TB lesions was also illustrated. They responded to aggressive anti- TB and anti-inflammatory therapies. CONCLUSIONS: The diagnosis and management of ocular TB can pose a significant challenge. Physicians and ophthalmologists must include TB among the differential diagnoses of patients with ocular inflammatory diseases and treat ocular TB with a combination of anti-TB and immunosuppressive medications as needed. Immunosuppressive medications applied in this setting must be cautioned and only prescribed by ophthalmologists who are familiar with these agents.
Authors: Marjorie M Conant; Chuck R Vrasich; Jeff V Wongskhaluang; Kevin Ferenchak; Matthew K Asano; Norbert Becker; Patricia DeMarais Journal: Open Forum Infect Dis Date: 2015-12-15 Impact factor: 3.835
Authors: A G T A Kariyawasam; C L Fonseka; P U T De Silva; A D S S Sanjeewa; D N Wijewickrama; H M M Herath; T P Weerarathna Journal: Case Rep Infect Dis Date: 2020-01-31