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Tuberculosis

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Emerging Infectious Uveitis

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Abstract

Ocular tuberculosis (TB) usually occurs without concomitant systemic TB, and its diagnosis is presumed by a set of clinical signs and corroborative laboratory evidence. Recently, there is a growing evidence of ocular TB from non-endemic countries too. Animal models of ocular TB have suggested a hematogenous spread of Mycobacterium tuberculosis (MTB), although the exact pathogenesis remains unclear. It has protean manifestations and can affect any part of the eye. Retinal vasculitis, choroidal tubercles, and multifocal serpiginoid choroiditis are commonly associated with tubercular posterior uveitis. Routine workup includes tuberculin skin test, or interferon gamma release assays, radiography (chest X ray or CT scan), and exclusion of other causes of uveitis. A favorable response to antitubercular therapy (ATT) has shown a strong association of latent TB with ocular TB. Definitive evidence by polymerase chain reaction (PCR) of intraocular fluids is limited by its low sensitivity. Newer PCR-based tests have the advantages of quicker results and detection of drug resistance. Treatment with ATT (and corticosteroids) is highly effective in reducing recurrences.

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  1. Advanced Eye Centre, PGIMER, Chandigarh, India

    Amod Gupta & Reema Bansal

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  1. Amod Gupta
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  1. Singapore National Eye Center, Singapore, Singapore

    Soon-Phaik Chee

  2. Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir, Tunisia

    Moncef Khairallah

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Gupta, A., Bansal, R. (2017). Tuberculosis. In: Chee, SP., Khairallah, M. (eds) Emerging Infectious Uveitis. Springer, Cham. https://doi.org/10.1007/978-3-319-23416-8_7

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