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Clinical presentation, treatment, and outcomes in presumed intraocular tuberculosis: experience from Newcastle upon Tyne, UK

Lookup NU author(s): Dr Edmund OngORCiD, Andrew Browning, Dr Ranjeet Pandit

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Abstract

Purpose To report the clinical manifestations and treatment outcomes of patients with presumed intraocular tuberculosis (TB) seen at the Newcastle Uveitis Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK over a 10-year period.Methods Retrospective review of case notes.Results A total of 21 patients were identified. Occlusive retinal vasculitis was the commonest ophthalmological presentation (12 patients). Eight patients (38%) were found to have underlying active systemic TB (four with mediastinal lymphadenopathy, three with pulmonary TB, one with cutaneous TB). Constitutional or respiratory symptoms, elevated inflammatory markers, and an abnormal chest radiograph were poor indicators of active TB. Two patients had inactive intrathoracic TB. Eleven patients had latent TB. Eighteen patients received anti-tuberculous treatment. Final visual acuity was better than or equal to initial visual acuity in 14 out of 16 patients who completed at least 6 months of standard anti-tuberculous treatment.Conclusions Most patients with presumed intraocular TB have latent TB, but a significant minority has hitherto undetected active TB. Our series suggests that either proven or presumed intraocular TB occurs frequently in the absence of constitutional or respiratory symptoms, elevated inflammatory markers, or an abnormal chest radiograph. A minimum of 6 months standard anti-tuberculous treatment provides good visual outcomes in the majority of patients. Eye (2013) 27, 480-486; doi:10.1038/eye.2013.11; published online 22 February 2013

Publication metadata

Author(s): Manousaridis K, Ong E, Stenton C, Gupta R, Browning AC, Pandit R

Publication type: Article

Publication status: Published

Journal: Eye

Year: 2013

Volume: 27

Issue: 4

Pages: 480-486

Print publication date: 01/04/2013

Online publication date: 22/02/2013

Acceptance date: 12/01/2013

ISSN (print): 0950-222X

ISSN (electronic): 1476-5454

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/eye.2013.11

DOI: 10.1038/eye.2013.11

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