Kurup Shree K, Chan Chi-Chao
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892-1857, USA.
Ann Acad Med Singap. 2006 Mar;35(3):203-9.
Worldwide, there are approximately 8 million new cases and 3 million deaths from tuberculosis (TB) each year. TB affects the entire body and the eye. Although ocular TB is considered rare, its incidence has varied widely across time, patient populations, and geography. We report 2 patients with unique presentations of ocular TB and detail the treatment and outcome of the disease.
Two cases of ocular inflammation, one with a medical history of systemic TB and the other, with that of presumed systemic TB, were examined. Choroidal granuloma developed in one, and scleritis developed in the other. The literature on ocular TB was comprehensively reviewed.
Both patients were diagnosed with ocular TB. The histology of the systemic TB lesions was also illustrated. They responded to aggressive anti- TB and anti-inflammatory therapies.
The diagnosis and management of ocular TB can pose a significant challenge. Physicians and ophthalmologists must include TB among the differential diagnoses of patients with ocular inflammatory diseases and treat ocular TB with a combination of anti-TB and immunosuppressive medications as needed. Immunosuppressive medications applied in this setting must be cautioned and only prescribed by ophthalmologists who are familiar with these agents.
在全球范围内，每年约有800万例新发结核病病例，300万人死于结核病。结核病会影响全身，也会累及眼睛。尽管眼部结核病被认为较为罕见，但其发病率在不同时间、患者群体和地域间差异很大。我们报告了2例眼部结核病的独特病例，并详细介绍了该病的治疗方法及结果。
检查了2例眼部炎症患者，其中1例有全身性结核病病史，另1例推测有全身性结核病病史。1例出现脉络膜肉芽肿，另1例出现巩膜炎。我们全面回顾了关于眼部结核病的文献。
2例患者均被诊断为眼部结核病。文中还展示了全身性结核病变的组织学情况。他们对积极的抗结核和抗炎治疗有反应。
眼部结核病的诊断和管理可能是一项重大挑战。内科医生和眼科医生必须将结核病纳入眼部炎症性疾病患者的鉴别诊断中，并根据需要联合使用抗结核药物和免疫抑制药物来治疗眼部结核病。在这种情况下应用免疫抑制药物必须谨慎，且只能由熟悉这些药物的眼科医生开具处方。
