Skip to main content


Log in

Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript


Purpose To define the clinical characteristics and optical coherence tomographic (OCT) features, and to assess the outcome of treatment, in patients with presumed tuberculous uveitis (PTU). Methods All patients diagnosed with PTU at King Abdulaziz University Hospital between January 1998 and May 2006 were reviewed. The diagnosis was made when findings were consistent with possible intraocular tuberculosis with no other cause of uveitis suggested by history, symptoms, or ancillary testing, strongly positive tuberculin skin-test results, and response to antituberculous therapy. Results Fifty-one patients (73 eyes) were identified. There were 34 males (66.7%) and 17 females (33.3%) with a mean age of 40.1 ± 11.0 years (range 16–68 years). Fifty-eight eyes (79.5%) had panuveitis and 15 eyes (20.5%) had posterior uveitis at presentation. Clinical manifestations included vitritis (71.2%), macular edema (63%), retinal periphlebitis (35.6%), multifocal choroiditis (20.5%), and granulomatous anterior uveitis (17.9%). All patients received antituberculous therapy and systemic corticosteroids. After a mean follow-up of 18.9 ± 21.9 months (range 6–96 months), all eyes showed resolution of inflammation, with no recurrences, associated with significant improvement in visual acuity (VA) (P = 0.007). There was a significant positive correlation between initial and final VAs (r = 0.7856, P < 0.001). Thirty-one eyes with macular edema were examined at baseline and at follow-up with OCT. There were three patterns of macular edema: diffuse (DME) (28.5%), cystoid (29%), and serous retinal detachment (45.2%). Initial VA of 20/40 or better was significantly associated with central macular thickness (CMT) of 300 μm or less (P = 0.0065) and DME (0.0484). At final follow-up, there was a significant reduction in CMT (P < 0.001) associated with a significant improvement in VA (P = 0.0091). Conclusions Antituberculous therapy combined with systemic corticosteroids leads to resolution of inflammation and elimination of recurrences of PTU. OCT is useful in monitoring the efficacy of treatment in patients with macular edema.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others


  1. Gupta A, Gupta V, Arora S, Dogra MR, Bambery P (2001) PCR-positive tubercular retinal vasculitis. Clinical characteristics and management. Retina 21:435–444

    Article  PubMed  CAS  Google Scholar 

  2. Marimura Y, Okada AA, Kawahara S, Miyamoto Y, Kawai S, Hirakata A, Hida T (2002) Tuberculin skin testing in uveitis patients and treatment of presumed intraocular tuberculosis in Japan. Ophthalmology 109:851–857

    Article  Google Scholar 

  3. Rosen PH, Spalton DJ, Graham EM (1990) Intraocular tuberculosis. Eye 4:486–492

    PubMed  Google Scholar 

  4. Gupta V, Arora S, Gupta A, Ram J, Bambery P, Sehgal S (1998) Management of presumed intraocular tuberculosis: possible role of the polymerase chain reaction. Acta Ophthalmol Scand 35:237–239

    Google Scholar 

  5. Gupta V, Gupta A, Arora S, Bambery P, Dogra MR, Agarwal A (2003) Presumed tubercular serpiginouslike choroiditis. Clinical presentation and management. Ophthalmology 110:1744–1749

    Article  PubMed  Google Scholar 

  6. Sakai J-I, Matsuzawa S, Usui M, Yano I (2001) New diagnostic approach for ocular tuberculosis by ELISA using the cord factor as antigen. Br J Ophthalmol 85:130–133

    Article  PubMed  CAS  Google Scholar 

  7. Sarvananthan N, Wiselka M, Bibby K (1998) Intraocular tuberculosis without detectable systemic infection. Arch Ophthalmol 116:1386–1388

    PubMed  CAS  Google Scholar 

  8. Abu El-Asrar AM, AL-Kharashi SA (2002) Full panretinal photocoagulation and early vitrectomy improve prognosis of retinal vasculitis associated with tuberculoprotein hypersensitivity (Eales’ disease). Br J Ophthalmol 86:1248–1251

    Article  Google Scholar 

  9. Biswas J, Madhavan HN, Gopal L, Badrinath SS (1995) Intraocular tuberculosis. Clinicopathologic study of five cases. Retina 15:461–468

    PubMed  CAS  Google Scholar 

  10. Helm CJ, Holland GN (1993) Ocular tuberculosis. Surv Ophthalmol 38:229–256

    Article  PubMed  CAS  Google Scholar 

  11. Sheu S-J, Shyu J-S, Chen L-M, Chen Y-YU, Chirn S-C, Wang J-S (2001) Ocular manifestations of tuberculosis. Ophthalmology 108:1580–1585

    Article  PubMed  CAS  Google Scholar 

  12. Wolfensberger TJ, Piguet B, Herbort CP (1999) Indocyanine green angiographic features in tuberculous chorioretinitis. Am J Ophthalmol 127:350–353

    Article  PubMed  CAS  Google Scholar 

  13. Lardenoye CWTA, Van Kooij B, Rothova A (2006) Impact of macular edema on visual acuity in uveitis. Ophthalmology 113:1446–1449

    Article  PubMed  Google Scholar 

  14. AlKuraya H, Kangave D, Abu El-Asrar AM (2005) The correlation between optical coherence tomographic features and severity of retinopathy, macular thickness and visual acuity in diabetic macular edema. Int Ophthalmol 26:93–99

    Article  PubMed  Google Scholar 

  15. Kim BY, Smith SD, Kaiser PK (2006) Optical coherence tomographic patterns of diabetic macular edema. Am J Ophthalmol 142:405–412

    Article  PubMed  Google Scholar 

  16. Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127:688–693

    Article  PubMed  CAS  Google Scholar 

  17. Kang SW, Park CY, Ham D-I (2004) The correlation between fluorescein angiographic and optical coherence tomographic features in clinically significant diabetic macular edema. Am J Ophthalmol 137:313–322

    Article  PubMed  Google Scholar 

  18. Yamamoto S, Yamamoto T, Hayashi M, Takeuchi S (2001) Morphological and functional analyses of diabetic macular edema by optical coherence tomography and multifocal electroretinograms. Graefe’s Arch Clin Exp Ophthalmol 239:96–101

    Article  CAS  Google Scholar 

  19. Antcliff RJ, Stanford MR, Chauhan DS, Graham EM, Spalton DJ, Shilling JS, Ffytche TJ, Marshall J (2000) Comparison between optical coherence tomography and fundus fluorescein angiography for the detection of cystoid macular edema in patients with uveitis. Ophthalmology 107:593–599

    Article  PubMed  CAS  Google Scholar 

  20. Markomichelakis NN, Halkiadakis J, Pantelia E, Peponis V, Patelis A, Theodossiadis P, Theodossiadis G (2004) Patterns of macular edema in patients with uveitis. Qualitative and quantitative assessment using optical coherence tomography. Ophthalmology 111:946–953

    Article  PubMed  Google Scholar 

  21. Rowland K, Guthmann R, Jamieson B (2006) How should we manage a patient with positive PPD and prior BCG vaccination? J Fam Pract 55:718–720

    PubMed  Google Scholar 

  22. Bodaghi B, LeHoang P (2000) Ocular tuberculosis. Curr Opin Ophthalmol 11:442–448

    Google Scholar 

  23. Rao NA, Saraswathy S, Smith RE (2006) Tuberculous uveitis: distribution of Mycobacterium tuberculosis in the retinal pigment epithelium. Arch Ophthalmol 124:1777–1779

    Article  PubMed  Google Scholar 

  24. Yanoff M, Fine BS, Brucker AJ, Eagle RC Jr (1984) Pathology of human cystoid macular edema. Surv Ophthalmol 28(Suppl):505–511

    Article  PubMed  Google Scholar 

Download references


The authors thank Ms Connie B. Unisa-Marfil for secretarial work.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ahmed M. Abu El-Asrar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Al-Mezaine, H.S., Al-Muammar, A., Kangave, D. et al. Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. Int Ophthalmol 28, 413–423 (2008).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: