Degree, duration, and causes of visual impairment in eyes affected with ocular tuberculosis

Abstract

BackgroundOcular tuberculosis (TB) can affect nearly every ocular tissue, leading to a variety of vision-threatening clinical manifestations. The goal of this study is to estimate the degree, duration, and causes of visual impairment in eyes affected by ocular TB.ResultsThis was a retrospective study of patients diagnosed as ocular TB based on polymerase chain reaction (PCR) for Mycobacterium tuberculosis complex. We applied the World Health Organization definition of visual impairment (VI) to affected eye(s), instead of better-seeing eye. Best-corrected visual acuity (BCVA) of <6/18 and ≥6/60 in the affected eye was classified as moderate VI and <6/60 and ≥3/60 as severe VI. Data collected included presenting and final BCVA of affected eyes and the worst BCVA during the study period. Sixty-one eyes of 40 patients were analyzed. Twenty-five patients (52.1%) had bilateral disease. The mean worst BCVA and mean final BCVA (logMAR) were 1.26 ± 0.87 and 0.61 ± 0.85, respectively, and their difference was highly significant (p < 0.0001, Friedman test). The median worst and final BCVA results were 1.30 (range 0.0 to 3.0) and 0.20 (range 0.0 to 3.0), respectively. The mean duration of follow-up was 98.34 ± 81.81 weeks. Moderate and severe VIs were seen in 14 (22.9%) and 12 (19.7%) eyes, respectively, during the course of follow up. Twenty eyes (32.8%) had BCVA of <3/60. Moderate VI or worse was most commonly seen in eyes with multifocal serpiginoid choroiditis (n = 6; 100%), retinal vasculitis (n = 25; 80.6%), and panuveitis (n = 12; 80%). The mean duration of visual loss was 25.2 ± 42.37 weeks (median 6.43 weeks, range 0 to 206.42 weeks). Vitreous hemorrhage, complicated cataract, and macular scarring were the common causes of VI.ConclusionOcular TB can result in prolonged visual impairment, more commonly in patients with posterior uveitis or panuveitis.

Autoreactive T Cells in Immunopathogenesis of TB-Associated Uveitis

“…3 Delay in diagnosis and management of TBU leads to prolonged ocular inflammation and eventual vision loss. 4,5 TB of the eye has several unique features that are generally not found in other forms of extrapulmonary TB. It is an extremely paucibacillary infection, involving an immuneprivileged organ, and has multiple clinical phenotypes, such as retinal vasculitis or choroiditis, all of which are clinically visible through optically clear media.…”

Global Variations and Challenges With Tubercular Uveitis in the Collaborative Ocular Tuberculosis Study

“…8 Ocular involvement most often manifests as uveitis, and it has been reported in up to one-fifth of patients with culture-proven TB, [10][11][12] along with significant associated ocular morbidity and visual loss. [12][13][14] It is initially asymptomatic in most patients 10,15 and can be the first presentation of TB infection, 16 given that affected patients may not have symptoms of active pulmonary TB. [17][18][19] However, despite progress in coordinated efforts to address pulmonary TB, the approach to manage tubercular uveitis (TBU) remains controversial due to a lack of robust data.…”

Tüberkülozun nadir bir formu: Sklera tüberkülozu

“…12 Oküler tüberküloz uzun süreli görme bozukluğuna neden olabilir. 13 Oküler tüberkülozun tanısı zordur. Tam bir fizik muayene, TDT ve göğüs radyografisi tanıya yardımcıdır.…”