Clinical profile of intraocular tuberculosis patients and its relationship with pulmonary tuberculosis

Ahmad Zeeshan Jamil; Zahid Kamal; Muhammad Waseem; Muhammad Junaid Iqbal; Nauman Aziz; Muhammad Luqman Ali Bahoo

Abstract
Objective: To describe the clinical profile of intraocular tuberculosis (TB) patients and its relationship with pulmonary TB.
Methodology: This cross-sectional descriptive study was conducted in ophthalmology department of district headquarter teaching hospital, Sahiwal Medical College, Sahiwal, Pakistan from January 2016 to December 2019. There were 48 patients with intraocular TB. History of past TB or contact with TB was recorded. Detailed ocular examination was performed. All patients were also examined by pulmonologist. Anti-tuberculosis therapy comprising of Isoniazid, Rifampicin, Pyrazinamide and Ethambutol was given to all the patients. Systemic corticosteroids were given to selected patients with intense intraocular inflammation involving macula, disc or blood vessels.
Results: Mean age of patients was 33.04±13.66 years. Male were 31(64.6%). Out of 48 cases, 42(87.5%) had bilateral intraocular TB. Presenting complaints were decreased vision (81.3%), floaters (12.5%) and pain (6.3%). T-spot test was positive in 44(91.7%) cases. X-ray chest showed abnormal findings in 30(62.5%) cases. Anti-tuberculosis therapy resulted in complete resolution of intraocular inflammation in 93.7% cases. There was significant improvement in visual acuity after treatment.
Conclusion: Intraocular TB is not common in cases of active pulmonary TB. In most cases ophthalmologist was the first to make a diagnosis. Anti-tuberculosis therapy should be started in cases of intraocular inflammation where positive immunological laboratory tests and suggestive radiological findings were present. Management of intraocular inflammation with anti-tuberculosis therapy results in visual improvement, resolution of the disease and less frequent recurrences.

Key words: Choroiditis, tuberculosis, uveitis.

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