Skip to main content

Ocular Tuberculosis

  • Chapter
  • First Online:
Extrapulmonary Tuberculosis
  • 551 Accesses

Abstract

Periocular or intraocular infection mainly by Mycobacterium species is defined as “ocular tuberculosis” (ocular TB), which mainly occurs by hematogenous dissemination of the pulmonary and extrapulmonary TB. The most common clinical presentation of ocular tuberculosis is uveitis, with posterior uveitis being the most common followed by anterior uveitis, panuveitis, and intermediate uveitis.

Definitive diagnosis may be achieved by examination of smears and staining for acid-fast organisms and cultures of intraocular tissue/fluid for Mycobacterium tuberculosis.

The current treatment of intraocular TB consists of use of isoniazid, rifampicin, ethambutol, and pyrazinamide for a long period of time.

Since ocular TB is a masquerading disease with different clinical manifestations, with no gold standard test for a certain diagnosis, an empirical clinical approach, including ocular and systemic examination, laboratory testing of the bacillus in the intraocular fluids and tissues by direct microscopy, culture, or PCR, is needed to make a definitive diagnosis.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Shakarchi FI. Ocular tuberculosis: current perspectives. Clin Ophthalmol. 2015;9:2223–7. https://doi.org/10.2147/OPTH.S65254.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jabbar A, Khan J, Ullah A, Rehman H, Ali I. Detection of Mycobacterium tuberculosis and Mycobacterium bovis from human sputum samples through multiplex PCR. Pak J Pharm Sci. 2015;28(4):1275–80.

    CAS  PubMed  Google Scholar 

  3. Biswas J, Badrinath SS. Ocular morbidity in patients with active systemic tuberculosis. Int Ophthalmol. 1995–1996;19:293–8.

    Article  Google Scholar 

  4. Abu El-Asrar AM, Abouammoh M, Al-Mezaine HS. Tuberculous uveitis. Middle East Afr J Ophthalmol. 2009;16(4):188–201. https://doi.org/10.4103/0974-9233.58421.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Woods AC. Modern concepts of the etiology of uveitis. Am J Ophthalmol. 1960;50:1170–87.

    Article  CAS  Google Scholar 

  6. Samson MC, Foster CS. Tuberculosis. In: Foster CS, Vitale AT, editors. Diagnosis and treatment of uveitis. Philadelphia: WB Saunders Company; 2002. p. 264–72.

    Google Scholar 

  7. Woods AC, Abrahams IW. Uveitis survey sponsored by the American Academy of Ophthalmology and Otolaryngology. Am J Ophthalmol. 1961;51:761–80.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  9. Donahue HC. Ophthalmologic experience in a tuberculosis sanatorium. Am J Ophthalmol. 1967;64:742–8.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  11. Yang P, Zhang Z, Zhou H, Li B, Huang X, Gao Y, et al. Clinical patterns and characteristics of uveitis in a tertiary canter for uveitis in China. Curr Eye Res. 2005;30:943–8.

    Article  Google Scholar 

  12. 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 

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

    Article  Google Scholar 

  14. Norn M. [Ophthalmic tuberculosis, especially in Denmark]. Dan Medicinhist Arbog. 2001;212–8.

    Google Scholar 

  15. Khokkanen VM, Iagafarova RK. Clinical and epidemiological characteristics of patients with eye tuberculosisProbl Tuberk. 1998;6:14–5.

    Google Scholar 

  16. Kazokoglu H, Onal S, Tugal-Tutkun I, et al. Demographic and clinical features of uveitis in tertiary centers in Turkey. Ophthalmic Epidemiol. 2008;15:285–93.

    Article  Google Scholar 

  17. Alvarez S, McCabe WR. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine (Baltimore). 1984;63(1):25–55.

    Article  CAS  Google Scholar 

  18. Al-Shakarchi F. Mode of presentations and management of presumed tuberculous uveitis at a referral center. Iraqi Postgrad Med J. 2015;14(1):91–5.

    Google Scholar 

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

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  21. Bodaghi B, LeHoang P. Ocular tuberculosis. Curr Opin Ophthalmol. 2000;11:443–8.

    Article  CAS  Google Scholar 

  22. Ray S, Gragoudas E. Neuroretinitis. Int Ophthalmol Clin. 2001;41:83–102.

    Article  CAS  Google Scholar 

  23. Slavin RE, Walsh TJ, Pollack AD. Late generalized tuberculosis: a clinical pathologic analysis and comparison of 100 cases in the preantibiotic and antibiotic eras. Medicine (Baltimore). 1980;59:352–66.

    Article  CAS  Google Scholar 

  24. Varma D, Anand S, Reddy AR, et al. Tuberculosis: an under-diagnosed aetiological agent in uveitis with an effective treatment. Eye (Lond). 2006;20:1068–73.

    Article  CAS  Google Scholar 

  25. Feng Y, Diao N, Shao L, et al. Interferon-gamma release assay performance in pulmonary and extrapulmonary tuberculosis. Chabalgoity JA, ed. PLoS One. 2012;7(3):e32652. https://doi.org/10.1371/journal.pone.0032652.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Ang M, Wong W, Ngan CC, Chee SP. Interferon-gamma release assay as a diagnostic test for tuberculosis-associated uveitis. Eye. 2012;26(5):658–65.

    Article  CAS  Google Scholar 

  27. Gupta A, Gupta V. Tubercular posterior uveitis. Int Ophthalmol Clin. 2005;45:71–88.

    Article  Google Scholar 

  28. Gupta A, Sharma A, Bansal R, Sharma K. Classification of intraocular tuberculosis. Ocul Immunol Inflamm. 2015;23(1):7–13. https://doi.org/10.3109/09273948.2014.967358.

    Article  PubMed  Google Scholar 

  29. Onal S, Tutkun IT. Ocular tuberculosis I: epidemiology, pathogenesis and clinical features. Turk J Ophthalmol. 2011;41:171–81.

    Article  Google Scholar 

  30. Onal S, Tutkun IT. Ocular tuberculosis II: diagnosis and treatment. Turk J Ophthalmol. 2011;41:182–90.

    Article  Google Scholar 

  31. 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  Google Scholar 

  32. Centers for Disease Control and Prevention (CDC); American Thoracic Society. Update: adverse event data and revised American Thoracic Society/CDC recommendations against the use of rifampin and pyrazinamide for treatment of latent tuberculosis infection--United States, 2003. MMWR Morb Mortal Wkly Rep. 2003;52:735–9.

    Google Scholar 

  33. Bıçakcı F, Ozeren A, Yerdelen D, Sarica Y. Etambutol kullanımına bağlı optik nöropati. Turkiye Klinikleri J Med Sci. 2005;25:460–2.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Comez, A.T. (2019). Ocular Tuberculosis. In: Sener, A., Erdem, H. (eds) Extrapulmonary Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-04744-3_14

Download citation

Publish with us

Policies and ethics