Abstract
Objective To observe the ocular manifestations of presumed ocular tuberculosis in patients with pulmonary tuberculosis.Methods One hundred and fifty nine patients with pulmonary tuberculosis received examinations of visual acuity,slit lamp microscopy and indirect ophthalmoscopy.Those patients with retinochoroidal inflammatory lesions,retinal hemorrhages or detachments underwent fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) to determine whether the presumed ocular tuberculosis was involved.There were 9 patients (16 eyes,5.67％) of presumed ocular tuberculosis,including 5 males and 4 females.The age was ranged from 19 to 64 years old,with an average of 35.12 years.Seven patients were affected bilaterally and 2 patients affected unilaterally.There were 8 patients (15eyes,93.75％) with uveitis and 1 patient (1 eye,6.25％) with central retinal vein occlusion (CRVO).The blood laboratory tests were negative in all cases.Results The corrected vision was from light sensation to 0.15 in 6 uveitis eyes,0.8 to 1.0 in 10 eyes.The anterior segment change was found in 10 eyes,which including granulomatous uveitis (8 eyes) and non-granulomatous uveitis (2 eyes).Granulomatous uveitis eyes had iris nodules,posterior synechia of the iris and mutton-fat keratic precipitates (KP).Nongranulomatous uveitis eyes had KP only.Choroidal tubercles were found in 7 eyes in which 3-7 off-white lesions of varying sizes were found with local retinal detachment.FFA revealed hypo-fluorescence with obscure boundary in arterial phase and arterial and venous phase,and hyper-fluorescence with obscure boundary in later phase.OCT showed retinal pigment epithelium uplift.There was 1 eye with CRVO,which had punctate,splinter and linear hemorrhage,white lesions in some hemorrhagic focus.Conclusion The presumed ocular tuberculosis eyes showed mainly granulomatous inflammation and multiple choroid tubercles,and CRVO sometime. Key words: Tuberculosis,ocular/diagnosis; Tuberculosis, pulmonary/complications
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