L Figueira1, S Fonseca1, I Ladeira2, R Duarte3. 1. Portuguese Society of Ophthalmology, Lisboa, Portugal. 2. Portuguese Society of Pulmonology, Lisboa, Portugal. 3. Portuguese Society of Pulmonology, Lisboa, Portugal; Tuberculosis National Program, Portugal. Electronic address: raquelafduarte@gmail.com.
Abstract
Delay in diagnosis or treatment of ocular tuberculosis can result in loss of vision. However, due to the fact that early diagnosis is rarely achieved, there are still a broad variety of diagnostic and treatment approaches. Our aim was to reach a consensus on the management of diagnosis and treatment of ocular tuberculosis. METHODS: Critical appraisal of the literature and expert opinion on diagnosis and treatment of ocular tuberculosis. RESULTS AND CONCLUSION: The currently recommended method for ocular TB diagnosis is screening for tuberculosis in any uveitis of unknown etiology, recurrent or not responding to conventional therapy; in ocular findings highly suggestive of ocular TB and before immunosuppression (particularly biologic agents). TB screening in these cases includes tuberculosis skin testing and interferon gamma testing, along with complete medical history, ophthalmologic evaluation and chest imaging. Positively screened patients should be treated for active tuberculosis with 4 drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) for 6-9 months. Patients should be reviewed at the end of the initiation phase (two months) and at the end of the overall treatment (6-9 months).
Delay in diagnosis or treatment of ocular tuberculosis can result in loss of vision. However, due to the fact that early diagnosis is rarely achieved, there are still a broad variety of diagnostic and treatment approaches. Our aim was to reach a consensus on the management of diagnosis and treatment of ocular tuberculosis. METHODS: Critical appraisal of the literature and expert opinion on diagnosis and treatment of ocular tuberculosis. RESULTS AND CONCLUSION: The currently recommended method for ocular TB diagnosis is screening for tuberculosis in any uveitis of unknown etiology, recurrent or not responding to conventional therapy; in ocular findings highly suggestive of ocular TB and before immunosuppression (particularly biologic agents). TB screening in these cases includes tuberculosis skin testing and interferon gamma testing, along with complete medical history, ophthalmologic evaluation and chest imaging. Positively screened patients should be treated for active tuberculosis with 4 drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) for 6-9 months. Patients should be reviewed at the end of the initiation phase (two months) and at the end of the overall treatment (6-9 months).
Authors: Ruchi Shah; Cynthia Amador; Kati Tormanen; Sean Ghiam; Mehrnoosh Saghizadeh; Vaithi Arumugaswami; Ashok Kumar; Andrei A Kramerov; Alexander V Ljubimov Journal: Exp Eye Res Date: 2021-01-21 Impact factor: 3.467
Authors: M La Cava; A Bruscolini; M Sacchetti; M P Pirraglia; A Moramarco; M Marenco; G Iaiani; G Covelli; T Rizzo; I Abicca; A Lambiase Journal: J Ophthalmol Date: 2020-03-14 Impact factor: 1.909