Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Eye (Lond). 2013 Apr;27(4):480-6. doi: 10.1038/eye.2013.11. Epub 2013 Feb 22.
To report the clinical manifestations and treatment outcomes of patients with presumed intraocular tuberculosis (TB) seen at the Newcastle Uveitis Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK over a 10-year period.
Retrospective review of case notes.
A total of 21 patients were identified. Occlusive retinal vasculitis was the commonest ophthalmological presentation (12 patients). Eight patients (38%) were found to have underlying active systemic TB (four with mediastinal lymphadenopathy, three with pulmonary TB, one with cutaneous TB). Constitutional or respiratory symptoms, elevated inflammatory markers, and an abnormal chest radiograph were poor indicators of active TB. Two patients had inactive intrathoracic TB. Eleven patients had latent TB. Eighteen patients received anti-tuberculous treatment. Final visual acuity was better than or equal to initial visual acuity in 14 out of 16 patients who completed at least 6 months of standard anti-tuberculous treatment.
Most patients with presumed intraocular TB have latent TB, but a significant minority has hitherto undetected active TB. Our series suggests that either proven or presumed intraocular TB occurs frequently in the absence of constitutional or respiratory symptoms, elevated inflammatory markers, or an abnormal chest radiograph. A minimum of 6 months standard anti-tuberculous treatment provides good visual outcomes in the majority of patients.
报告在英国泰恩河畔纽卡斯尔的纽卡斯尔葡萄膜炎服务中心，10 年间就诊的疑似眼内结核（TB）患者的临床表现和治疗结果。
回顾性病例分析。
共确定了 21 名患者。闭塞性视网膜血管炎是最常见的眼科表现（12 例）。有 8 名患者（38%）发现存在活动性全身 TB（4 例纵隔淋巴结肿大，3 例肺结核，1 例皮肤结核）。全身或呼吸系统症状、炎症标志物升高和异常胸部 X 线均不能很好地提示活动性 TB。2 名患者有陈旧性胸内 TB。11 名患者有潜伏性 TB。18 名患者接受了抗结核治疗。16 名完成至少 6 个月标准抗结核治疗的患者中，有 14 名最终视力优于或等于初始视力。
大多数疑似眼内 TB 患者有潜伏性 TB，但少数患者存在先前未发现的活动性 TB。本研究表明，即使没有全身或呼吸系统症状、炎症标志物升高或异常胸部 X 线，也可能经常发生明确或疑似的眼内 TB。大多数患者接受至少 6 个月的标准抗结核治疗后，视力恢复良好。
