title: Diagnosis of Ocular Tuberculosis.
abstract: Ocular tuberculosis remains a presumptive clinical diagnosis, as the gold standard tests for diagnosing ocular tuberculosis are often not useful: Mycobacterium tuberculosis cultures require weeks to process on Lowenstein-Jenson media and have low yield from ocular samples; while acid-fast bacilli smears or polymerase chain reaction detection of M. tuberculosis DNA have low sensitivities. Thus, diagnosis is often based on suggestive clinical signs, which are supported by positive investigations: tuberculin skin test or interferon-gamma release assays; chest X-ray findings suggestive of pulmonary tuberculosis, and/or evidence of associated systemic tuberculosis infections in the absence of other underlying disease. The aim of this review is to provide an update on the methods of diagnosing ocular tuberculosis, and discuss the challenges of its diagnosis. We also suggest a step-ladder approach to a more accurate diagnosis of ocular tuberculosis by combining the available diagnostic tests.
authors.affiliation: a Singapore National Eye Centre , Singapore.|b Singapore Eye Research Institute , Singapore.|c Yong Loo Lin School of Medicine, National University of Singapore , Singapore.|d Department of Ophthalmology and Visual Sciences , Duke-National University of Singapore, Graduate Medical School , Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.affiliation: e Department of Ophthalmology , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.|f Hospital São Geraldo/HC - Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
authors.forename: Daniel V
authors.initials: DV
authors.lastname: Vasconcelos-Santos
authors.affiliation: g Department of Medical Microbiology, Internal Medicine , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Kusum
authors.initials: K
authors.lastname: Sharma
authors.affiliation: h Department of Ophthalmology , Sapienza University of Rome , Rome , Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Accorinti
authors.affiliation: g Department of Medical Microbiology, Internal Medicine , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Aman
authors.initials: A
authors.lastname: Sharma
authors.affiliation: g Department of Medical Microbiology, Internal Medicine , Postgraduate Institute of Medical Education and Research , Chandigarh , India.|i Department of Ophthalmology , Postgraduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
authors.affiliation: j USC Eye Institute , Los Angeles , USA.|k Keck School of Medicine, University of Southern California , Los Angeles , USA.
authors.forename: Narsing A
authors.initials: NA
authors.lastname: Rao
authors.affiliation: a Singapore National Eye Centre , Singapore.|b Singapore Eye Research Institute , Singapore.|c Yong Loo Lin School of Medicine, National University of Singapore , Singapore.|d Department of Ophthalmology and Visual Sciences , Duke-National University of Singapore, Graduate Medical School , Singapore.
authors.forename: Soon-Phaik
authors.initials: SP
authors.lastname: Chee
mesh_terms: D003941:Diagnostic Techniques, Ophthalmological; D006801:Humans; D059425:Interferon-gamma Release Tests; D016133:Polymerase Chain Reaction; D013902:Radiography, Thoracic; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
keywords: Ocular tuberculosis; chest X-ray; interferon-gamma (IFN-γ) release assay (IGRA); polymerase chain reaction (PCR); tuberculin skin test