Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Ocul Immunol Inflamm. 2011 Oct;19(5):370-2. doi: 10.3109/09273948.2011.594203. Epub 2011 Aug 11.
To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection.
A young man presented with sudden onset of decreased vision in his left eye with combined optic disc swelling and central retinal artery occlusion in a background of vasculitic changes of the same eye. There were no signs or symptoms of active systemic tuberculosis infection. Chest X-ray and computed tomography thorax findings were normal and sputum cultures for tuberculosis were negative. The Mantoux and QuantiFERON-TB Gold tests were strongly positive. No tuberculosis polymerase chain reaction testing was done. Anti-tuberculosis therapy was initiated, based on the strong clinical evidence.
The ocular findings improved remarkably with the anti-tuberculosis treatment, although the left eye vision remained poor. A high index of suspicion is required to diagnose ocular tuberculosis when all other systemic investigations are negative, especially in this part of the world where tuberculosis is endemic.
报告一例疑似眼结核而无全身感染的合并视神经病变和视网膜中央动脉阻塞的罕见病例。
一名年轻男性左眼突发视力下降，伴有视盘肿胀和视网膜中央动脉阻塞，同时伴有同眼血管炎改变。无活动性全身结核感染的迹象或症状。胸部 X 线和胸部计算机断层扫描结果正常，痰液结核培养阴性。曼托和 QuantiFERON-TB Gold 试验均呈强阳性。未进行结核聚合酶链反应检测。根据强烈的临床证据，开始进行抗结核治疗。
尽管左眼视力仍然较差，但随着抗结核治疗，眼部病变明显改善。当所有其他全身检查均为阴性时，尤其是在结核病流行的这一地区，需要高度怀疑眼结核的诊断。
