title: Presumed tuberculosis-induced retinal vasculitis, diagnosed with positron emission tomography (18F-FDG-PET/CT), aspiration biopsy, and culture.
abstract: OBJECTIVE
  The diagnosis of tuberculosis as an etiological factor in patients with uveitis is difficult because of lack of specific diagnostic tests. The authors report 2 cases of occlusive retinal vasculitis, in which (18)F-FDG-PET/CT was helpful for the diagnosis of tuberculosis as a presumptive cause of intraocular inflammation.
  
  
  METHODS
  In 2 patients with severe occlusive retinal vasculitis and positive QuantiFERON TB-Gold test, (18)F-FDG-PET/CT, transbronchial needle-aspiration biopsy, and microbiological investigation were performed.
  
  
  RESULTS
  (18)F-FDG-PET/CT showed increased fluorodeoxyglucose uptake in some mediastinal and hilar lymph nodes. After needle-aspiration biopsy of PET-positive lymph nodes, M. tuberculosis was recovered in culture in both cases. Remission of uveitis was achieved only after a combination therapy with 3 anti-tubercular agents and systemic steroids.
  
  
  CONCLUSIONS
  The authors favor the use of (18)F-FDG-PET/CT in patients with sight-threatening intraocular inflammation and positive interferon-gamma release assay. Anti-tubercular therapy, together with anti-inflammatory treatment, may lead to a remission in such patients.
authors.affiliation: Center for Ophthalmology, University of Tuebingen, Tuebingen, Germany. deshka_doycheva@yahoo.com
authors.forename: Deshka
authors.initials: D
authors.lastname: Doycheva
authors.forename: Christina
authors.initials: C
authors.lastname: Pfannenberg
authors.forename: Juergen
authors.initials: J
authors.lastname: Hetzel
authors.forename: Christoph M E
authors.initials: CM
authors.lastname: Deuter
authors.forename: Carlos
authors.initials: C
authors.lastname: Pavesio
authors.forename: Volkhard A J
authors.initials: VA
authors.lastname: Kempf
authors.forename: Eva
authors.initials: E
authors.lastname: Schuelen
authors.forename: Philip
authors.initials: P
authors.lastname: Aschoff
authors.forename: Narsing
authors.initials: N
authors.lastname: Rao
authors.forename: Manfred
authors.initials: M
authors.lastname: Zierhut
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000379:methods*; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D005451:Fluorescein Angiography; D019788:Fluorodeoxyglucose F18; D005654:Fundus Oculi; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D008297:Male; D008482:Mediastinum; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000382:microbiology; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D004269:DNA, Bacterial; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18