Ocular manifestations of tuberculosis.
OBJECTIVE
To present the clinical and histopathologic findings in five cases of tuberculosis (TB) with various ocular manifestations.


METHODS
Observational case series.


METHODS
Retrospective review of clinical findings, course, and treatment of five patients. Diagnostic techniques, including biomicroscopic, histopathologic, and molecular biologic test results, are presented.


METHODS
Visual acuity, slit-lamp biomicroscopy, indirect ophthalmoscopy, and fluorescein angiography results.


RESULTS
The ocular manifestations of TB in our patients included panophthalmitis, endophthalmitis, posterior uveitis with choroidal tubercles, keratitis, and a lid mass. Mycobacterium tuberculosis was identified in four cases in ocular specimens using acid-fast bacilli microscopy and in three cases by culture. Rapid diagnosis using polymerase chain reaction was obtained in one case. Extraocular foci of TB were identified in three cases with an intraocular infection at presentation. No patients had the human immunodeficiency virus (HIV) and none were immunocompromised. Two eyes could not be saved using antituberculous treatment because of delayed diagnosis and treatment.


CONCLUSIONS
In this age of the HIV pandemic, TB is becoming more common. Because it is curable, heightened awareness and better understanding of the disease's ocular manifestations should be of concern to all ophthalmologists.
Sheu
S J
SJ
Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. sjsheu@isca.vghks.gov.tw
Shyu
J S
JS
Chen
L M
LM
Chen
Y Y
YY
Chirn
S C
SC
Wang
J S
JS
D000368:Aged; D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D010202:Panophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015866:Uveitis, Posterior / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014792:Visual Acuity
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents