Shahidatul-Adha M, Zunaina E, Liza-Sharmini A T, Wan-Hazabbah W H, Shatriah I, Mohtar I, Azhany Y, Adil H
Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Ann Med Surg (Lond). 2017 Oct 13;24:25-30. doi: 10.1016/j.amsu.2017.10.003. eCollection 2017 Dec.
Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by , a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated.
To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM).
A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016.
The mean age was 43 ± 14.6 years old. Both male and female affected in about 1:1 ratio. The majority of subjects were local Malays (91.2%). Risk factors included previous contact with pulmonary TB patients (38.2%), and patients with underlying diabetes mellitus (26.5%). Most patients showed normal chest radiography (79.4%). However they had positive Mantoux test (94.1%) and raised erythrocyte sedimentation rate (ESR) value (58.8%). Uveitis was the most common ocular manifestation of ocular TB (70.6%) while the rare ocular manifestations included optic perineuritis and optic neuritis, orbital apex syndrome, orbital cellulitis, sclerokeratitis, corneal ulcer and conjunctival abscess. All patients responded well to anti-TB treatment, but visual outcome was variable.
This review shows the diverse entity of ocular TB spectrum in an endemic area. Good clinical response to anti-tuberculous therapy supported the presumed diagnosis of ocular TB in majority of the cases.
眼部结核病涵盖了影响眼睛不同结构的广泛临床表现。它由一种古老的微生物引起,如果未被识别和妥善治疗,会引发各种类型的疾病和不良后果。
报告马来西亚理科大学医院(HUSM)在6年期间观察到的34例眼部结核病病例的临床概况。
对2011年1月至2016年12月在HUSM诊断为眼部结核病的34例患者的病历进行回顾性研究。
平均年龄为43±14.6岁。男性和女性的患病比例约为1:1。大多数受试者是当地马来人(91.2%)。危险因素包括既往接触肺结核患者(38.2%)和患有基础糖尿病的患者(26.5%)。大多数患者胸部X线检查正常(79.4%)。然而,他们结核菌素试验呈阳性(94.1%)且红细胞沉降率(ESR)值升高(58.8%)。葡萄膜炎是眼部结核病最常见的眼部表现(70.6%),而罕见的眼部表现包括视神经周围炎和视神经炎、眶尖综合征、眼眶蜂窝织炎、巩膜角膜炎、角膜溃疡和结膜脓肿。所有患者对抗结核治疗反应良好,但视力结果各不相同。
本综述显示了流行地区眼部结核病谱的多样性。对抗结核治疗的良好临床反应支持了大多数病例中眼部结核病的推测诊断。