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ocular tuberculosis

Description

Ocular Tuberculosis: A Complex Infection

Ocular tuberculosis (TB) is an extrapulmonary mycobacterial infection that can affect any part of the eye, including intraocular, superficial, or surrounding structures [2]. The reported incidence of ocular involvement varies considerably, making it a complex and challenging condition to diagnose and treat.

Symptoms and Manifestations

The symptoms of ocular tuberculosis can be varied and may include:

  • Blurred vision
  • Light sensitivity
  • Floaters or flashes in the eye
  • Headache
  • Yellowish-white lesions on the surface of the eye [4]

In severe cases, acute tuberculous panophthalmitis can occur, characterized by painless, progressive loss of vision, decreased motility of the eye, cloudy cornea, and signs of granulomatous ocular inflammation [5].

Types of Ocular TB

Ocular TB can be categorized into extraocular and intraocular forms. Extraocular TB affects structures around and on the eye, while intraocular TB involves structures within the eye [3]. The prognosis for ocular TB is extremely doubtful due to its chronic and persistent course [7].

Causes and Risk Factors

Ocular TB is primarily caused by infection with Mycobacterium tuberculosis, which can affect any part of the eye. The risk factors for developing ocular TB are not well understood, but it is believed to be related to the severity of pulmonary TB and the presence of other extrapulmonary manifestations [9].

Conclusion

In conclusion, ocular tuberculosis is a complex and potentially severe infection that requires prompt diagnosis and treatment. Understanding its symptoms, manifestations, and risk factors can help healthcare professionals provide accurate diagnoses and effective care for patients affected by this condition.

References:

[1] Not provided in the context

[2] Context #6

[3] Context #3

[4] Context #4

[5] Context #5

[6] Not provided in the context

[7] Context #7

[8] Not provided in the context

[9] Context #9

Additional Characteristics

  • extrapulmonary mycobacterial infection
  • can affect any part of the eye, including intraocular, superficial, or surrounding structures
  • complex and challenging condition to diagnose and treat
  • varied symptoms: blurred vision, light sensitivity, floaters or flashes in the eye, headache, yellowish-white lesions on the surface of the eye
  • acute tuberculous panophthalmitis: painless, progressive loss of vision, decreased motility of the eye, cloudy cornea, and signs of granulomatous ocular inflammation
  • extraocular TB affects structures around and on the eye
  • intraocular TB involves structures within the eye
  • prognosis for ocular TB is extremely doubtful due to its chronic and persistent course

Signs and Symptoms

Symptoms of Ocular Tuberculosis

Ocular tuberculosis can manifest in various ways, leading to a range of symptoms. According to the available information [1], some common symptoms include:

  • Blurred vision
  • Light sensitivity
  • Eye floaters or flashes
  • Headache

If left untreated, ocular TB can result in permanent structural changes to the eyes, potentially leading to vision loss or blindness [2].

Common Manifestations

The most common chief complaints associated with ocular TB are: * Red eye (30%) * Painful eye (30%) * Blurry vision (30%) * Photophobia (10%) * Reduced vision (10%) [3][4]

In some cases, ocular TB can present as lid abscess, conjunctival infiltration, or other signs of infection [5].

Signs and Symptoms

Some notable signs and symptoms associated with ocular TB include: * Yellowish lesions with poorly defined borders and

Additional Symptoms

Diagnostic Tests

Diagnosing Ocular Tuberculosis: A Comprehensive Overview

Ocular tuberculosis (TB) is a rare but serious manifestation of TB that affects the eyes. Diagnosing ocular TB can be challenging, as it often presents with non-specific symptoms and requires a combination of clinical suspicion, laboratory tests, and imaging studies.

Diagnostic Tests for Ocular Tuberculosis:

  • Tuberculin Skin Test (TST): Also known as the Mantoux test, this is a century-old test that assesses the presence of immunological memory against Mtb antigens. However, it has limited sensitivity and specificity in diagnosing ocular TB [7].
  • Interferon-Gamma Release Assays (IGRAs): These tests measure the release of interferon-gamma by T-cells in response to Mtb antigens. IGRAs are more specific than TSTs but may not be as sensitive in detecting ocular TB [2].
  • Quantiferon Gold Test: This is a type of IGRA that has been shown to be useful in diagnosing ocular tuberculosis, especially when used in combination with other tests [3].
  • High-Resolution Computed Tomography (HRCT): HRCT scans can help identify the presence of TB in the eyes and surrounding tissues. They are particularly useful in cases where other confirmatory tests are not available [4].
  • DNA Amplification Tests: PCR can identify TB DNA in ocular fluids, which may indicate active intraocular TB rather than a latent infection [5].

Clinical Suspicion and Laboratory Testing

Diagnosing ocular TB often requires a high degree of clinical suspicion. Laboratory testing, including serologic tests to rule out other conditions, is also essential. A combination of these approaches can help confirm the diagnosis and guide treatment.

References:

  • [1] The definitive diagnosis of TB is established by isolation of M tuberculosis bacilli from ocular tissues.
  • [2] by M Ang · 2018 · Cited by 61 — Thus, diagnosis is often based on suggestive clinical signs, which are supported by positive investigations: tuberculin skin test or interferon-gamma release ...
  • [3] by JKS Tsui · 2023 · Cited by 7 — TB test and QuantiFERON gold test are useful in the diagnosis of ocular tuberculosis.
  • [4] Oct 27, 2018 — We concluded that HRCT has an important role in the accurate diagnosis of ocular tuberculosis, especially in the absence of other confirmatory ...
  • [5] by OM Kon · 2022 · Cited by 21 — DNA amplification tests by PCR can identify TB DNA in ocular fluids. If present this may demonstrate active intraocular TB rather than a ...

Additional Diagnostic Tests

  • Tuberculin Skin Test (TST)
  • Interferon-Gamma Release Assays (IGRAs)
  • Quantiferon Gold Test
  • High-Resolution Computed Tomography (HRCT)
  • DNA Amplification Tests

Treatment

Treatment Options for Ocular Tuberculosis

Ocular tuberculosis, also known as tuberculous uveitis, is a rare but serious form of tuberculosis that affects the eyes. The treatment of ocular tuberculosis typically involves a combination of anti-tuberculosis (

Recommended Medications

  • Corticosteroids
  • Anti-tuberculosis medications

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Differential Diagnosis of Ocular Tuberculosis

Ocular tuberculosis (TB) can be challenging to diagnose due to its varied manifestations and similarity in symptoms with other conditions. The differential diagnosis for ocular TB includes:

  • Histoplasmosis: A fungal infection that can cause uveitis, similar to ocular TB.
  • Toxocariasis: An parasitic infection caused by Toxocara species, which can lead to uveitis and retinal damage.
  • Sarcoidosis: A systemic disease characterized by the formation of granulomas in various organs, including the eyes.
  • Syphilis: A bacterial infection that can cause uveitis and other ocular symptoms.
  • Toxoplasmosis: A parasitic infection caused by Toxoplasma gondii, which can lead to uveitis and retinal damage.
  • Acute Retinal Necrosis (ARN): A rare condition characterized by rapid progression of retinitis, often associated with viral infections.

These conditions can mimic the symptoms of ocular TB, making differential diagnosis crucial for accurate treatment. According to [7], tuberculous uveitis is a great mimicker of various uveitis entities and it can be considered in the differential diagnosis of any type of intraocular inflammation.

In addition, tuberculomas may resemble melanoma or retinoblastoma, highlighting the importance of thorough examination and diagnostic testing to rule out ocular TB [4].

It is essential for physicians to consider ocular TB as a potential diagnosis in patients with uveitis, particularly those from endemic regions or with immunocompromised status [5].

Additional Information

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