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Infections of the Posterior Segment: Ocular Tuberculosis

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Ocular Infections

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

In recent years, ocular involvement due to tuberculosis has reemerged. Tuberculous uveitis is a readily treatable disease, and the consequences of delay in either ocular or systemic diagnosis can be very serious for the patient. It is important to have a high index of suspicion of the diagnosis in patients with unexplained chronic uveitis, and this will be influenced by the socioeconomic circumstances, family history, ethnic origin, and previous medical history of the patient. Treatment with antituberculous therapy combined with systemic corticosteroids induces resolution of inflammation with no recurrences after stopping antituberculous therapy and systemic corticosteroids.

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References

  1. Centers for Disease Control and Prevention. Case definitions for infectious conditions under public health surveillance. MMWR Recomm Rep. 1997;46:1–55.

    Google Scholar 

  2. Glassroth J, Robins AG, Snider DE. Tuberculosis in the 1980s. N Engl J Med. 1980;302:1441–50.

    Article  CAS  PubMed  Google Scholar 

  3. Baydur A. The spectrum of extrapulmonary tuberculosis. West J Med. 1977;126:253–62.

    CAS  PubMed Central  PubMed  Google Scholar 

  4. Kazokoglu H, Onal S, Tugal-Tutkun I, Mirza E, Akova Y, Ozyazgan Y, Soylu M, Batioglu F, Apaydin C. Demographic and clinical features of uveitis in tertiary centers in Turkey. Ophthalmic Epidemiol. 2008;15:285–93.

    Article  PubMed  Google Scholar 

  5. Pathanapitoon K, Kunavisarut P, Ausayakhun S, Sirirungsi W, Rothova A. Uveitis in a tertiary ophthalmology centre in Thailand. Br J Ophthalmol. 2008;92:474–8.

    Article  CAS  PubMed  Google Scholar 

  6. Khairallah M, Yahia SB, Ladjimi A, Messaoud R, Zaouali S, Attia S, Jenzeri S, Jelliti B. Pattern of uveitis in a referral centre in Tunisia, North Africa. Eye. 2007;21:33–9.

    Article  CAS  PubMed  Google Scholar 

  7. Rathinam SR, Namperumalsamy P. Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol. 2007;55:173–83.

    Article  CAS  PubMed  Google Scholar 

  8. Yang P, Zhang Z, Zhou H, Li B, Huang X, Gao Y, Zhu L, Ren Y, Klooster J, Kijlstra A. Clinical patterns and characteristics of uveitis in a tertiary canter for uveitis in China. Curr Eye Res. 2005;30(11):943–8.

    Article  PubMed  Google Scholar 

  9. Sengun A, Karadag R, Karakurt A, Saricaoglu MS, Abdik O, Hasiripi H. Causes of uveitis in a referral hospital in Ankara, Turkey. Ocul Immunol Inflamm. 2005;13:45–50.

    Article  PubMed  Google Scholar 

  10. Soheilian M, Heidari K, Yazdani S, Shahsavari M, Ahmadieh H, Dehghan M. Patterns of uveitis in a tertiary eye care center in Iran. Ocul Immunol Inflamm. 2004;12:297–310.

    Article  PubMed  Google Scholar 

  11. Singh R, Gupta V, Gupta A. Pattern of uveitis in a referral eye clinic in north India. Indian J Ophthalmol. 2004;52:121–5.

    PubMed  Google Scholar 

  12. Wakabayashi T, Morimura Y, Miyamoto Y, Okada AA. Changing pattern of intraocular inflammatory disease in Japan. Ocul Immunol Inflamm. 2003;11:277–86.

    Article  PubMed  Google Scholar 

  13. Islam SM, Tabbara KF. Causes of uveitis at The Eye Center in Saudi Arabia: a retrospective review. Ophthalmic Epidemiol. 2002;9:239–49.

    Article  PubMed  Google Scholar 

  14. Mercanti A, Parolini B, Bonora A, Lequaglie Q, Tomazzoli L. Epidemiology of endogenous uveitis in north-eastern Italy. Analysis of 655 new cases. Acta Ophthalmol Scand. 2001;79:64–8.

    Article  CAS  PubMed  Google Scholar 

  15. KaimboWaKimbo D, Bifuko A, Dernouchamps JP, Missotten L. Chronic uveitis in Kinshasa (D R Congo). Bull Soc Belge Ophthalmol. 1998;270:95–100.

    CAS  Google Scholar 

  16. Kotake S, Furudate N, Sasamoto Y, Yoshikawa K, Goda C, Matsuda H. Characteristics of endogenous uveitis in Hokkaido, Japan. Graefes Arch Clin Exp Ophthalmol. 1997;235:5–9.

    Article  CAS  PubMed  Google Scholar 

  17. Merrill PT, Kim J, Cox TA, Betor CC, McCallum RM, Jaffe GJ. Uveitis in southeastern United States. Curr Eye Res. 1997;16:865–74.

    Article  CAS  PubMed  Google Scholar 

  18. Rodriguez A, Calonge M, Pedroza-Seres M, Akova YA, Messmer EM, D’Amico DJ, Foster CS. Referral pattern of uveitis in tertiary eye care center. Arch Ophthalmol. 1996;114:593–9.

    Article  CAS  PubMed  Google Scholar 

  19. Thean LH, Thompson J, Rosenthal AR. A uveitis register at the Leicester Royal Infirmary. Ophthalmic Epidemiol. 1996;3:151–8.

    Article  CAS  PubMed  Google Scholar 

  20. Smit RL, Baarsma GS, de Vries J. Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. Int Ophthalmol. 1993;17:71–6.

    Article  CAS  PubMed  Google Scholar 

  21. Rothova A, Buitenhuis HJ, Meenken C, Brinkman CJ, Linssen A, Alberts C, Luyendijk L, Kijlstra A. Uveitis and systemic disease. Br J Ophthalmol. 1992;76:137–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Weiner A, BenEzra D. Clinical patterns and associated conditions in chronic uveitis. Am J Ophthalmol. 1991;112:151–8.

    Article  CAS  PubMed  Google Scholar 

  23. Palmares J, Coutinho MF, Castro-Correia J. Uveitis in northern Portugal. Curr Eye Res. 1990;9(Suppl):31–4.

    Article  PubMed  Google Scholar 

  24. Henderly DE, Genstler AJ, Smith RE, Rao NA. Changing pattern of uveitis. Am J Ophthalmol. 1987;103:131–6.

    Article  CAS  PubMed  Google Scholar 

  25. Almezaine HS, Kangave D, Abu El-Asrar AM. Patterns of uveitis in patients admitted to a university hospital in Riyadh Saudi Arabia. Ocul Immunol Inflamm. 2010;18:424–31.

    Article  Google Scholar 

  26. Rosen PH, Spalton DJ, Graham EM. Intraocular tuberculosis. Eye. 1990;4:486–92.

    Article  PubMed  Google Scholar 

  27. Helm CJ, Holland GN. Ocular tuberculosis. Surv Ophthalmol. 1993;38:229–56.

    Article  CAS  PubMed  Google Scholar 

  28. Biswas J, Madhavan HN, Gopal L, Badrinath SS. Intraocular tuberculosis. Clinocopathologic study of five cases. Retina. 1995;15:461–8.

    Article  CAS  PubMed  Google Scholar 

  29. Sheu SJ, Shyu JS, Chen LM, Chen YY, Chirn SC, Wang JS. Ocular manifestations of tuberculosis. Ophthalmology. 2001;108:1580–5.

    Article  CAS  PubMed  Google Scholar 

  30. Sakai J-I, Matsuzawa S, Usui M, Yano I. New diagnostic approach for ocular tuberculosis by ELISA using the cord factor as antigen. Br J Ophthalmol. 2001;85:130–3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Gupta A, Gupta V, Arora S, Dogra MR, Bambery P. PCR-positive tubercular retinal vasculitis. Clinical characteristics and management. Retina. 2001;21:435–44.

    Article  CAS  PubMed  Google Scholar 

  32. Morimura Y, Okada AA, Kawahara S, Miyamoto Y, Kawai S, Hirakata A, Hida T. Tuberculin skin testing in uveitis patients and treatment of presumed intraocular tuberculosis in Japan. Ophthalmology. 2002;109:851–7.

    Article  PubMed  Google Scholar 

  33. Gupta V, Arora S, Gupta A, Ram J, Bambery P, Sehgal S. Management of presumed intraocular tuberculosis: possible role of the polymerase chain reaction. Acta Ophthalmol Scand. 1998;35:237–9.

    Google Scholar 

  34. Gupta V, Gupta A, Arora S, Bambery P, Dogra MR, Agarwal A. Presumed tubercular serpiginous-like choroiditis. Clinical presentation and management. Ophthalmology. 2003;110:1744–9.

    Article  PubMed  Google Scholar 

  35. Sarvananthan N, Wiselka M, Bibby K. Intraocular tuberculosis without detectable systemic infection. Arch Ophthalmol. 1998;116:1386–8.

    CAS  PubMed  Google Scholar 

  36. Abu El-Asrar AM, Al-Kharashi SA. Full panretinal photocoagulation and early vitrectomy improve prognosis of retinal vasculitis associated with tuberculoprotein hypersensitivity (Eales’ disease). Br J Ophthalmol. 2002;86:1248–51.

    Article  Google Scholar 

  37. Wolfensberger TJ, Piguet B, Herbort CP. Indocyanine green angiographic features in tuberculouschorioretinitis. Am J Ophthalmol. 1999;127:350–3.

    Article  CAS  PubMed  Google Scholar 

  38. Mackensen F, Becker MD, Wiehler U, Max R, Dalpke A, Zimmermann S. QuantiFERON TB-Gold − a new test strengthening long-suspected tuberculous involvement in serpiginous-like choroiditis. Am J Ophthalmol. 2008;146:761–6.

    Article  PubMed  Google Scholar 

  39. Gupta V, Gupta A, Rao NA. Intraocular tuberculosis – an update. Surv Ophthalmol. 2007;52:561–87.

    Article  PubMed  Google Scholar 

  40. Cimino L, Herbort CP, Aldigeri R, Salvarani C, Boiardi L. Tuberculous uveitis, a resurgent and undiagnosed disease. Int Ophthalmol. 2009;29:67–74.

    Article  PubMed  Google Scholar 

  41. Bansal R, Gupta A, Gupta V, Dogra MR, Bambery P, Arora SK. Role of anti-tubercular therapy in uveitis with latent/manifest tuberculosis. Am J Ophthalmol. 2008;146:772–9.

    Article  CAS  PubMed  Google Scholar 

  42. Tabbara KF. Tuberculosis. Curr Opin Ophthalmol. 2007;18:493–501.

    Article  PubMed  Google Scholar 

  43. Al-Mezaine HS, Al-Muammar A, Kangave D, Abu El-Asrar AM. Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. Int Ophthalmol. 2008;28:413–23.

    Article  PubMed  Google Scholar 

  44. Demirci H, Shields CL, Shields JA, Eagle Jr RC. Ocular tuberculosis masquerading as ocular tumors. Surv Ophthalmol. 2004;49:78–89.

    Article  PubMed  Google Scholar 

  45. Bansal R, Gupta A, Gupta V, Dogra MR, Sharma A, Bambery P. Tubercular serpiginous-like choroiditis presenting as multifocal serpiginoidchoroiditis. Ophthalmology. 2012;119:2334–42.

    Article  PubMed  Google Scholar 

  46. Gupta A, Bansal R, Gupta V, Sharma A, Bambery P. Ocular signs predictive of tubercular uveitis. Am J Ophthalmol. 2010;149:562–70.

    Article  PubMed  Google Scholar 

  47. Ang M, Hedayatfar A, Zhang R, Chee SP. Clinical signs of uveitis associated with latent tuberculosis. Clin Experiment Ophthalmol. 2012;40:689–96.

    Article  PubMed  Google Scholar 

  48. Alvarez S, McCabe WR. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine (Baltimore). 1984;63:25–55.

    Article  CAS  Google Scholar 

  49. Rowland K, Guthmann R, Jamieson B, Malloy B. Clinical inquiries. How should we manage a patient with positive PPD and prior BCG vaccination? J Fam Pract. 2006;55:718–20.

    PubMed  Google Scholar 

  50. Pollock NR, Campos-Neto A, Kashino S, Napolitano D, Behar SM, Shin D, Sloutsky A, Joshi S, Guillet J, Wong M, Mardell E. Discordant Quanti FERON-TB Gold test results among US healthcare workers with increased risk of latent tuberculosis infection: a problem or solution? Infect Control Hosp Epidemiol. 2008;29:878–86.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Mazurek GH, Zajdowicz MJ, Hankinson AL, Costigan DJ, Toney SR, Rothel JS, Daniels LJ, Pascual FB, Shang N, Keep LW, LoBue PA. Detection of Mycobacterium tuberculosis infection in United States navy recruits using the tuberculin skin test or whole-blood interferon-gamma release assays. Clin Infect Dis. 2007;45:826–36.

    Article  CAS  PubMed  Google Scholar 

  52. Kurup SK, Buggage RR, Clarke GL, Ursea R, Lim WK, Nussenblatt RB. Gamma interferon assay as an alternative to PPD skin testing in selected patients with granulomatous intraocular inflammatory disease. Can J Ophthalmol. 2006;41:737–40.

    Article  PubMed  Google Scholar 

  53. Ang M, Htoon HM, Chee SP. Diagnosis of tuberculous uveitis: clinical application of an interferon-gamma release assay. Ophthalmology. 2009;116(7):1391–6.

    Article  PubMed  Google Scholar 

  54. Babu K, Satish V, Satish S, et al. Utility of QuantiFERON TB gold test in a South Indian patient population of ocular inflammation. Indian J Ophthalmol. 2009;57:427–30.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Gineys R, Bodaghi B, Carcelain G, et al. QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol. 2011;152(3):433–40.

    PubMed  Google Scholar 

  56. Llorenç V, González-Martin J, Keller J, Rey A, Pelegrín L, Mesquida M, Adán A. Indirect supportive evidence for diagnosis of tuberculosis-related uveitis: from the tuberculin skin test to the new interferon gamma release assays. Acta Ophthalmol. 2013;91:e99–107.

    Article  PubMed  Google Scholar 

  57. Honoré-Bouakline S, Vincensini JP, Giacuzzo V, Lagrange PH, Hermann JL. Rapid diagnosis of extrapulmonary tuberculosis by PCR: impact of sample preparation and DNA extraction. J Clin Microbiol. 2003;41:2323–9.

    Article  PubMed Central  PubMed  Google Scholar 

  58. Mehta S. Role of computed chest tomography (CT scan) in tuberculous retinal vasculitis. Ocul Immunol Inflamm. 2002;10:151–5.

    Article  PubMed  Google Scholar 

  59. Doycheva D, Deuter C, Hetzel J, et al. The use of positron emission tomography/CT in the diagnosis of tuberculosis-associated uveitis. Br J Ophthalmol. 2011;95:1290–4.

    Article  PubMed  Google Scholar 

  60. Abu El-Asrar AM, Abouammoh M, Al-Mezaine HS. Tuberculous uveitis. Int Ophthalmol Clin. 2010;50:19–39.

    Article  PubMed  Google Scholar 

  61. Abu El-Asrar AM, Almezaine HS. Anti-tuberculoustherapy combined with systemic corticosteroids improves retinal sensitivity in patients with active presumed tuberculous choroiditis. Int Ophthalmol. 2010;30:567–76.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, College of Medicine, King Saud University, KAUH, Old Airport Road, Box 245, Riyadh, 11411, Saudi Arabia

    Ahmed M. Abu El-Asrar MD, PhD, Marwan Abouammoh MD & Hani S. Al-Mezaine MD

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  1. Ahmed M. Abu El-Asrar MD, PhD
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  2. Marwan Abouammoh MD
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  3. Hani S. Al-Mezaine MD
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Corresponding author

Correspondence to Ahmed M. Abu El-Asrar MD, PhD .

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Editors and Affiliations

  1. Department of Ophthalmology, The Eye Center, Riyadh, Saudi Arabia

    Khalid F. Tabbara

  2. Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Saudi Arabia

    Ahmed M. Abu El-Asrar

  3. Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia

    Moncef Khairallah

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El-Asrar, A.M.A., Abouammoh, M., Al-Mezaine, H.S. (2014). Infections of the Posterior Segment: Ocular Tuberculosis. In: Tabbara, K., El-Asrar, A., Khairallah, M. (eds) Ocular Infections. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43981-4_9

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  • DOI: https://doi.org/10.1007/978-3-662-43981-4_9

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