Tuberculosis

Abstract

SummaryThe diagnosis of intraocular tuberculosis (TB) is often presumptive, made on the basis of suggestive ocular features, evidence of latent or manifest TB, exclusion of other causes of uveitis, and positive response to antitubercular treatment (ATT). The most typical features include serpiginous‐like choroiditis and occlusive retinal vasculitis. When the posterior segment is involved, treatment relies on ATT, usually in association with systemic or periocular corticosteroids. Patients should be monitored for response of inflammation to treatment, recurrences, adherence to ATT and treatment side‐effects. Clinical assessment of ocular TB at presentation and during follow‐up includes grading of vitreous haze, characterization of choroidal involvement, retinal vascular involvement and optic disc changes, and evaluation of anterior chamber cells and flare. Laser flare photometry may be used to monitor anterior chamber inflammation. Ocular imaging tests including fundus autofluorescence, fluorescein angiography, indocyanine green angiography, SD and EDI optical coherence tomography (OCT), and OCT angiography may be very useful in analyzing and quantifying specific TB retinal and choroidal changes.