Universidade Federal do Espírito Santo, Hospital Universitário Cassiano Antônio de Moraes, Departamento de Oftalmologia, Vitória, ES, Brazil.
Universidade Federal do Espírito Santo, Núcleo de Doenças Infecciosas, Vitória, ES, Brazil.
Braz J Infect Dis. 2018 May-Jun;22(3):159-165. doi: 10.1016/j.bjid.2018.03.005. Epub 2018 Apr 19.
Tuberculosis is an infectious disease of global importance with major economic and social burden accounting for 25% of all avoidable deaths in developing countries. Extrapulmonary involvement may occur either in association with clinically apparent pulmonary tuberculosis or in isolation. This cross-sectional descriptive study aimed to evaluate the impact of ocular tuberculosis in visual acuity at baseline and after two months of intensive anti-tuberculous therapy. A sample of 133 pulmonary tuberculosis patients, seven disseminated tuberculosis, and three pleural tuberculosis patients was evaluated. All patients underwent routine ophthalmic evaluation, including assessment of visual acuity, biomicroscopy, applanation tonometry, indirect ophthalmoscopy, and fluorescent angiography as appropriate. None of the patients had impaired visual acuity due to tuberculosis. A rate of 4.2% (6/143) of ocular involvement was found. None of the patients with ocular involvement were HIV-infected. Of the six patients with ocular involvement, five met the diagnostic criteria for probable and one for possible ocular lesions. As for the type of ocular lesions, two patients had bilateral findings: one had sclerouveitis and the second had choroidal nodules. The other four patients presented with unilateral lesions: peripheral retinal artery occlusion in the right eye (one case), choroidal nodules in the left eye (one case), and choroidal nodules in the right eye (two cases). Patients progressed favorably after two month of intensive therapy, with no significant reduction in vision.
结核病是一种具有全球重要性的传染病，在发展中国家造成的可避免死亡人数占 25%，造成了重大的经济和社会负担。肺外结核可能与明显的肺结核临床症状同时发生，也可能单独发生。本横断面描述性研究旨在评估眼部结核对基线视力和强化抗结核治疗两个月后的影响。评估了 133 例肺结核患者、7 例播散性肺结核患者和 3 例胸膜炎性肺结核患者。所有患者均接受常规眼科评估，包括视力评估、生物显微镜检查、压平眼压测量、间接检眼镜检查和荧光血管造影等。没有患者因结核病而视力受损。发现眼部受累率为 4.2%（6/143）。眼部受累的患者均未感染 HIV。在 6 例眼部受累的患者中，5 例符合可能和 1 例疑似眼部病变的诊断标准。眼部病变类型方面，2 例患者出现双眼病变：1 例为巩膜葡萄膜炎，另 1 例为脉络膜结节。其余 4 例为单侧病变：右眼视网膜动脉阻塞（1 例）、左眼脉络膜结节（1 例）和右眼脉络膜结节（2 例）。经过两个月的强化治疗后，患者病情好转，视力无明显下降。
