Reconciling the Ocular–Systemic Dichotomy in Tuberculosis: A Tale of Two Manifestations Revealed in a Series of 15 Patients
Accept poster if oral is not possible ?
Yes
Purpose
To elucidate the complex relationship between ocular and systemic TB through a retrospective analysis of 15 cases.
Methods
A retrospective comprehensive review of medical records, imaging modalities, and laboratory investigations was conducted for 15 patients presented with concurrent ocular and systemic TB to identify diagnostic patterns, treatment regimens, and clinical outcomes.
Results
Our findings demonstrated a diverse spectrum of ocular clinical manifestations. 8 patients had pulmonary TB and presented with chronic panuveitis, granulomatous anterior uveitis, subretinal abscess, and serpiginous choroiditis. 2 patients had spinal and meningeal involvement and presented with multifocal choroiditis and subretinal abscess respectively. 2 patients had abdominal TB and presented with tubercular choroidal and ciliary body granuloma. 1 rare case of frosted branch angiitis had abdominal TB. 2 patients had disseminated TB and presented with multiple choroidal tubercles. 1 patient had isolated TB of the lymph node and presented with a tuberculoma of the choroid.
After appropriate treatment, all patients responded well with good visual outcomes. We found that clinical suspicion along with intraocular fluid PCR for MTB supported by Mantoux and Quantiferon TB gold test helped to clinch the ocular diagnosis. HRCT chest, abdominal USG, spinal MRI, and Lymph node biopsy were added to the systemic diagnosis.
Conclusion
Concurrent Ocular and systemic tuberculosis is rare. This case series underscores the importance of considering systemic TB in patients with Ocular TB and vice-versa. A unified diagnostic and therapeutic framework is crucial to optimize patient outcomes.
Conflict of interest
No
1
Last name
BISWAS
Initials of first name(s)
J
Department
Director of Uveitis & Ocular Pathology Department, Sankara Nethralaya,
City
Chennai
Country
India
2
Last name
Ramya
Initials of first name(s)
N
Department
Department of Vitreoretina
City
Chennai
Country
India
3
Last name
Amare
Initials of first name(s)
AG
Department
Department of ophthalmology
City
Jimma
Country
Ethiopia
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