title: Combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without detectable systemic infection.
abstract: OBJECTIVE
  To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection.
  
  
  METHODS
  A young man presented with sudden onset of decreased vision in his left eye with combined optic disc swelling and central retinal artery occlusion in a background of vasculitic changes of the same eye. There were no signs or symptoms of active systemic tuberculosis infection. Chest X-ray and computed tomography thorax findings were normal and sputum cultures for tuberculosis were negative. The Mantoux and QuantiFERON-TB Gold tests were strongly positive. No tuberculosis polymerase chain reaction testing was done. Anti-tuberculosis therapy was initiated, based on the strong clinical evidence.
  
  
  CONCLUSIONS
  The ocular findings improved remarkably with the anti-tuberculosis treatment, although the left eye vision remained poor. A high index of suspicion is required to diagnose ocular tuberculosis when all other systemic investigations are negative, especially in this part of the world where tuberculosis is endemic.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Y L
authors.initials: YL
authors.lastname: Ooi
authors.forename: L Y
authors.initials: LY
authors.lastname: Tai
authors.forename: V
authors.initials: V
authors.lastname: Subrayan
authors.forename: I
authors.initials: I
authors.lastname: Tajunisah
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015356:Retinal Artery Occlusion / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents