Jolly Tsui1, Mary Ho1, Grace Lui2, Timothy Li2, Lijia Chen1, Lawrence Iu1, Marten Brelen1, Alvin L Young3. 1. Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole, The Chinese University of Hong Kong, Hong Kong SAR, China. 2. Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. 3. Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Miu Ling Nethersole, The Chinese University of Hong Kong, Hong Kong SAR, China. youngla@ha.org.hk.
Abstract
PURPOSE: To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment regimen and outcome in an endemic area. METHODS: This is a retrospective case series of patients with presumed OTB treated in a tertiary teaching hospital in Hong Kong in 2014-2019. RESULTS: Among the nineteen patients recruited, the most common clinical presentation of OTB was retinal vasculitis (42.1%), followed by scleritis, intermediate uveitis, and choroidal tuberculoma (15.8% respectively). 94.7% and 94.4% of the subjects were treated with ATT and steroid, respectively, and 31.6% were put on systemic immunosuppressant prior to the initiation of ATT. Apart from those suffering from intermediate uveitis, most demonstrated good clinical response within 8 weeks of ATT initiation. CONCLUSION: Ocular involvement of TB has been increasingly recognized, especially in endemic regions like Hong Kong. High index of suspicion is recommended for OTB in typical clinical phenotypes or recurrent/resistant ocular inflammation unresponsive to conventional therapy. TB retinal vasculitis was the most common presentation of OTB in this study and OTB generally requires treatment with either regional or systemic steroid together with ATT.
PURPOSE: To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment regimen and outcome in an endemic area. METHODS: This is a retrospective case series of patients with presumed OTB treated in a tertiary teaching hospital in Hong Kong in 2014-2019. RESULTS: Among the nineteen patients recruited, the most common clinical presentation of OTB was retinal vasculitis (42.1%), followed by scleritis, intermediate uveitis, and choroidal tuberculoma (15.8% respectively). 94.7% and 94.4% of the subjects were treated with ATT and steroid, respectively, and 31.6% were put on systemic immunosuppressant prior to the initiation of ATT. Apart from those suffering from intermediate uveitis, most demonstrated good clinical response within 8 weeks of ATT initiation. CONCLUSION: Ocular involvement of TB has been increasingly recognized, especially in endemic regions like Hong Kong. High index of suspicion is recommended for OTB in typical clinical phenotypes or recurrent/resistant ocular inflammation unresponsive to conventional therapy. TB retinal vasculitis was the most common presentation of OTB in this study and OTB generally requires treatment with either regional or systemic steroid together with ATT.
Authors: E C Leung; C C Leung; K C Chang; C K Chan; T Y Mok; K S Chan; K S Lau; C H Chau; W K Yee; W S Law; S N Lee; K F Au; L B Tai; W M Leung Journal: Hong Kong Med J Date: 2018-07-30 Impact factor: 2.227
Authors: Nicholas I Paton; Laurence Borand; Jubert Benedicto; Mar Mar Kyi; Asif Mujtaba Mahmud; Mohd Nor Norazmi; Nandini Sharma; Charoen Chuchottaworn; Yi-Wen Huang; Nastiti Kaswandani; Hoi Le Van; Grace C Y Lui; Tan Eang Mao Journal: Int J Infect Dis Date: 2019-07-10 Impact factor: 3.623