PURPOSE: To provide an up-to-date review of the clinical presentations, investigations, and management of orbital tuberculosis (OTB). METHODS: Systematic review of the literature concerning OTB, limiting the results to English-language peer-reviewed journals. RESULTS: Seventy-nine patients from 39 publications were identified as cases of OTB. The condition presents in one of five forms: classical periostitis; orbital soft tissue tuberculoma or cold abscess, with no bony involvement; OTB with bony involvement; spread from the paranasal sinuses; and tuberculous dacryoadenitis. The ocular adnexa, including the nasolacrimal system and overlying skin, may also be involved. CONCLUSIONS: Diagnosis can be difficult and may necessitate an orbital biopsy, in which acid-fast bacilli (AFB) and characteristic histopathology may be seen. Growth of Mycobacterium tuberculosis (mTB) from such a specimen remains the gold standard for diagnosis. Ancillary investigations include tuberculin skin tests and chest radiography, but more recently alternatives such as whole blood interferon-gamma immunological tests and PCR-based tests of pathological specimens have proven useful. The management of OTB is complex, requiring a stringent public health strategy and high levels of patient adherence, combined with long courses of multiple anti-tuberculous medications. The interaction of the human immunodeficiency virus (HIV) with TB may further complicate management.
PURPOSE: To provide an up-to-date review of the clinical presentations, investigations, and management of orbital tuberculosis (OTB). METHODS: Systematic review of the literature concerning OTB, limiting the results to English-language peer-reviewed journals. RESULTS: Seventy-nine patients from 39 publications were identified as cases of OTB. The condition presents in one of five forms: classical periostitis; orbital soft tissue tuberculoma or cold abscess, with no bony involvement; OTB with bony involvement; spread from the paranasal sinuses; and tuberculous dacryoadenitis. The ocular adnexa, including the nasolacrimal system and overlying skin, may also be involved. CONCLUSIONS: Diagnosis can be difficult and may necessitate an orbital biopsy, in which acid-fast bacilli (AFB) and characteristic histopathology may be seen. Growth of Mycobacterium tuberculosis (mTB) from such a specimen remains the gold standard for diagnosis. Ancillary investigations include tuberculin skin tests and chest radiography, but more recently alternatives such as whole blood interferon-gamma immunological tests and PCR-based tests of pathological specimens have proven useful. The management of OTB is complex, requiring a stringent public health strategy and high levels of patient adherence, combined with long courses of multiple anti-tuberculous medications. The interaction of the human immunodeficiency virus (HIV) with TB may further complicate management.
Authors: Rodrigo de Carvalho Santana; Paulo Louzada; Valdes Roberto Bollela; Antonio Augusto Vellasco Cruz; Benedito Antonio Lopes da Fonseca Journal: Int Ophthalmol Date: 2013-03-10 Impact factor: 2.031
Authors: Ellen J Davis; Sivakumar R Rathinam; Annabelle A Okada; Sharon L Tow; Harry Petrushkin; Elizabeth M Graham; Soon-Phaik Chee; Yan Guex-Crosier; Eva Jakob; Ilknur Tugal-Tutkun; Emmett T Cunningham; Jacqueline A Leavitt; Ahmad M Mansour; Kevin L Winthrop; William L Hills; Justine R Smith Journal: J Ophthalmic Inflamm Infect Date: 2012-05-22
Authors: Bekkay Rezzoug; Nazih Tzili; Hassan Ali; Oubaida Elyamouni; Mahfoud El Khaoua; Hamza Elorch; Redouane El Hlimi; Abdallah El Hassan; Amina Berraho Journal: Pan Afr Med J Date: 2015-01-12