Ocular lesions in acute disseminated tuberculosis.

PURPOSE

To determine the prevalence of ocular involvement in patients with acute disseminated tuberculosis and to assess the findings associated with ocular involvement.

METHODS

Assessment of all intensive care (ICU) admissions with a differential diagnosis of mycobacterial sepsis during a period of one year, with a detailed systemic and ophthalmic evaluation.

RESULTS

Of 342 admissions, 24 patients were suspected to have mycobacterial infection. Of these 24 cases, 10 were proven to have mycobacterial sepsis, six of which (60%) showed evidence of ocular involvement. Five (83%) of the six patients had choroidal tubercles and one (16%) had retinal vasculitis. Detection of the lesions allowed a lead time of 12-72 hours in which to start earlier targeted therapy.

CONCLUSIONS

Ocular involvement in acute disseminated tuberculosis is often seen, with the most common manifestation being choroidal tubercles. Early detection of these lesions may be important in treatment.