Abstract
Purpose
Orbital tuberculosis (TB) is a rare extra-pulmonary manifestation of tuberculosis and its clinical diagnosis poses unique challenges, with potential for destructive complications as well as social and public health implications. The aim of this study is to report our experience of patients presenting with orbital TB and to identify common aspects.
Methods
A systematic search for mandatory notifications of orbital tuberculosis between January 01, 1994 and December 12, 2016 was undertaken in the Victorian Tuberculosis database. In addition, members of the Australian and New Zealand Society of Ophthalmic Plastic Surgeons (ANZSOPS) were surveyed to identify cases of orbital tuberculosis diagnosed on biopsy in the past 20 years. Medical case notes of identified cases were reviewed retrospectively.
Results
Three cases were identified as having occurred in Victoria, aged 44–59 years old. All cases had emigrated from endemic countries with higher tuberculosis burden. Diagnosis of tuberculosis was often difficult due to few or non-viable acid fast bacilli and low yield of positive culture in paucicellular orbital specimens.
Conclusions
Orbital TB is rare but remains an important differential diagnosis of orbital mass lesions. The diagnosis of orbital TB requires a high index of clinical suspicion and targeted investigations in patients originating from endemic areas. Diagnosis and treatment rely on effective collaboration between ophthalmologists, infectious disease physicians, and pathologists.
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The study was approved by the Royal Victorian Eye and Ear Hospital Human Research and Ethics Committee.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
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The authors declare that they have no conflict of interest.
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Yao, A., Aboltins, C., McNab, A.A. et al. Orbital tuberculosis: perspectives from Victoria, Australia. Graefes Arch Clin Exp Ophthalmol 256, 2443–2448 (2018). https://doi.org/10.1007/s00417-018-4099-1
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DOI: https://doi.org/10.1007/s00417-018-4099-1