Cases Of Ocular Tuberculosis Research Articles

Spectrum of Ocular Tuberculosis in Tertiary Care Hospitals of Khyber Pakhtunkhwa Peshawar

Purpose: To describe the spectrum of ocular tuberculosis (TB), highlight the difficulty in diagnosis and treatment of such cases encountered in a tertiary care hospital of Peshawar, Pakistan. Study Design: Descriptive Case series. Place and Duration of Study: Khyber teaching hospital MTI Peshawar from Jan 2021 till July 2022. Methods: Eleven cases with Ocular tuberculosis are described. At presentation, complete history was taken and detailed examination was done including fundus examination and OCT macula. For diagnosis, a combination of Tuberculin skin test (TST) and Quantiferon-Gold was performed. On the basis of results of both tests Anti-TB treatment (ATT) was started and continued for an average of 9 months. Results: This study highlights the diverse ocular manifestations of TB in patients, even without a known history of systemic disease. Among 11 patients, 3 presented with panuveitis, 6 with posterior uveitis, and 2 with serpiginous-like choroidopathy with uveitis. Notably, only 2 had a known history of systemic TB. The patients were treated primarily with Anti-Tuberculosis Therapy (ATT) along with steroids or other adjunct therapies. Most cases showed improved vision and stable disease post-treatment, with visual acuity ranging from 6/24 to 6/6. However, two patients were lost to follow-up, leaving their outcomes unknown. Conclusion: In this case series, we explore different cases of Ocular Tuberculosis (OTB) seen at a busy hospital in Peshawar, Pakistan. There are variety of symptoms with which the patients present. The combined use of TST and Quantiferon-Gold proved an effective and affordable approach for diagnosis and timely initiation of ATT in ocular TB.

Ocular Tuberculosis; Different Clinical Presentation

Purpose: To present the diversity of clinical features, diagnostic approach with treatment outcome in four cases of ocular tuberculosis. Methods: An observational case series of four cases of ocular tuberculosis. Detail history, thorough ocular and systemic examination, Fundus fluorescein angiography, B-scan untrasonography ; Optical Coherence tomography scan, Erythrocyte Sedimentation Rate, Skin test for tubercle protein, histopathological examination of biopsy from lesion were performed according to the cases. Diagnosis was made by clinical history, ocular findings, appropriate ancillary tests and laboratory investigations according to the merit of the diseases. Response to anti tuberculous therapy (ATT) were observed which gave an anchor to the diagnosis. Results: Among four cases of ocular tuberculosis ,three were female last case was male and all of them were at or under the age of fourty. Two patients had extra ocular manifestation; one was tuberculous dacryoadenitis & other was tuberculous dacryocystitis. Two patients had eyeball involvement; one was tuberculous necrotizing scleritis, another one had tubercular vasculitis retinae. Out of four three had unilateral involvement. Three of them respond well to anti TB & anti inflammatory therapies; one respond to anti TB therapy only. Conclusions: Tuberculosis can affect any structure of eye and adnexae.The diagnosis is difficult because of diversity of presentation and most of the time there is absent of concurrent systemic infection. Early diagnosis and treatment can prevent blindness or severe ocular morbidity. In cases of non healing lesion and atypical inflammatory presentation, we stress the need for a high index of suspicion regarding tuberculosis.

Metastatic Pancreatic Neuroendocrine Tumor With Primary Presentation as Orbital Cellulitis

ABSTRACT Neuroendocrine tumors (NET) are rare malignancies of the gastrointestinal tract or lung with the most common metastases being the liver. Surgery remains the mainstay of treatment. We describe a 53-year-old woman with pancreatic NET metastatic to the liver, spleen, and orbital fossae. She presented with orbital cellulitis and was managed as a case of ocular tuberculosis after a preliminary ultrasound of the eye which showed soft-tissue edema of the orbit, and aspiration cytology showed ill-formed lymphocyte clusters. Eight weeks later, she developed antitubercular therapy-induced hepatitis. Further investigations revealed the real diagnosis of metastatic NET with orbital deposits. She received somatostatin analogue therapy, everolimus, and peptide receptor radionuclide therapy with significant reduction in size of lesions and resolution of symptoms.

The Incidence of Ocular Tuberculosis in Australia Over the Past 10 Years (2006–2015)

ABSTRACTPurpose: To determine the incidence and clinical phenotype of ocular tuberculosis in Australia based on the mandatory jurisdictional health notification records for TB.Methods: A whole population retrospective case series (Australia). Patients diagnosed with ocular tuberculosis were identified over the past 10 years (1 January 2006 to 31 December 2015) as recorded by individual Health Department jurisdictions per mandatory health notifications. The incidence rates were calculated based on the available Australian census data. Incidence rates were age and sex standardized.Results: A total of 162 cases of ocular tuberculosis were identified across Australia over a 10-year time period. Of these, 156 participants were overseas born. The 10-year Australian incidence of ocular tuberculosis was 0.77 per 100,000 people. While there has been a downward trend in overall TB annual incidence rates from 2010 to 2015, over the same period the annual incidence of ocular TB has increased compared to the 4 previous years. Descriptive clinical data regarding the ocular manifestations of TB was available in 73/157 patients. In these 73 patients the commonest manifestations of ocular TB were unspecified uveitis (50.1%), focal, multifocal or serpiginous choroiditis or chorioretinitis (12.3%) and retinal vasculitis (11.0%). Of patients with ocular TB, 4/162 (2.47%) had associated pulmonary TB and 8/162 (4.94%) had associated systemic (non-pulmonary) TB. Systemic anti-TB therapy was administered to 161 patients.Conclusions: The annual Australian incidence of ocular tuberculosis was 0.077 per 100,000 people. Increasing notifications in the past 6 years may demonstrate increased awareness and changing diagnostic criteria of the disease in the Australian population.

Clinical analysis of 12 cases of ocular tuberculosis

目的 探讨眼结核的临床特征,提高临床诊断水平.方法 回顾性分析近25年来确诊的12例眼结核的病例资料.结果 12例眼结核中,眼睑结核5例,眼眶、脉络膜结核各2例,球结膜、半月皱襞、泪囊结核各1例.临床表现为各个部位的占位病变或炎症.4例患者未发现眼外结核病灶,其余8例先后或同时患有肺结核、肠结核、小脑结核、睾丸结核、头颈部皮肤或淋巴结核.结论 眼部结核常表现为眼表新生物或眼眶、球内占位病变,确诊主要依靠病理检查.眼科医师应重视全身结核病史的询问,避免临床误诊。

Retinal detachment and bovine tuberculosis in cats

ABSTRACTBovine tuberculosis has been virtually eradicated from Britain. It was a disease to which cats were susceptible, mainly from the consumption of infected cow's milk. This report discusses four cases of ocular tuberculosis which, although of limited clinical significance today, could be of some value to veterinary clinical history. In the past, there has been a tendency to associate retinal haemorrhages with a choroidal tuberculosis, but with reference to the veterinary literature and two of the cases cited here, it would appear that either haemorrhage or uveitis, from whatever cause, is more likely to be linked to retinal detachment than to tuberculosis.