[Ways of optimizing the diagnosis and differential diagnosis of ocular tuberculosis].
The results of differential diagnostic study of 1035 patients with actual or suspected ocular tuberculosis in different aspects are analyzed. To define the diagnostic value of different signs, their comparative assessment was made via determination of the validity and informative value. Comparison of the findings with the efficiency of antituberculous therapy. In late posttherapeutical periods in particular was a reference for verification of the tuberculous etiology of eye diseases. There was strong evidence for the use of higher doses of tuberculin for diagnostic purposes due to its lower sensitivity. Focal tuberculin reactions were ascertained to be of no strict specificity and, if they were slightly pronounced, low informative value. The signs of the body's infection to tuberculin and of its sensitization were shown to suggest that the eye diseases might be of tuberculous etiology. A procedure for its verification was developed, based on the detection of specific ophthalmological picture, moderate or great focal tuberculin reactions by the type of inflammation and positive testing therapy with antituberculous agents. A programme (a system) of differentially diagnostic examination and an algorithm scheme aiding a physician to make a diagnosis and substantially reducing the frequency of misdiagnoses were proposed.
Ustinova
E I
EI
North-West Zone Managing Department of Sanatoriums, Department of Health of RF.
D000328:Adult; D002825:Chorioretinitis / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D014374:Tuberculin Test / Q000379:methods*; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000382:microbiology; D014605:Uveitis / Q000175:diagnosis / Q000209:etiology