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2015 ; 9
(ä): 2223-7
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Ocular tuberculosis: current perspectives
#MMPMID26648690
Shakarchi FI
Clin Ophthalmol
2015[]; 9
(ä): 2223-7
PMID26648690
show ga
The World Health Organization currently estimates that nearly two billion people,
or one-third of the world's population, are infected by tuberculosis, and that
roughly 10% of the infected people are symptomatic. Tuberculosis affects the
lungs in 80% of patients, while in the remaining 20% the disease may affect other
organs, including the eye. Uveitis can be seen concurrently with tuberculosis,
but a direct association is difficult to prove. Ocular tuberculosis is usually
not associated with clinical evidence of pulmonary tuberculosis, as up to 60% of
extrapulmonary tuberculosis patients may not have pulmonary disease. The
diagnosis of tuberculous uveitis is often problematic and in nearly all reported
cases, the diagnosis was only presumptive. Tuberculous uveitis is a great
mimicker of various uveitis entities and it can be considered in the differential
diagnosis of any type of intraocular inflammation. It is still unknown if ocular
manifestations result from a direct mycobacterium infection or hypersensitivity
reaction and this is reflected on the management of tuberculous uveitis.
Prevalence of tuberculosis as an etiology of uveitis may reach up to 10% in
endemic areas. Tuberculous uveitis is a vision-threatening disease that
inevitably leads to blindness if not properly diagnosed and treated. The aim of
this review is to illustrate the various clinical features and management of
presumed tuberculous uveitis. The current review focuses on the diagnostic
criteria, significance of tuberculin skin test, and use of systemic
corticosteroids in the management of tuberculous uveitis as recommended in recent
publications.