Department of Ophthalmology, Fundação Altino Ventura, Recife, Brazil.
Department of Ophthalmology, Hospital de Olhos Sadalla Amin Ghanem, Joinville, Brazil.
Retin Cases Brief Rep. 2021 Jan 1;15(1):56-61. doi: 10.1097/ICB.0000000000000747.
To report unique retinal fundus lesions and treatment outcomes of intraocular tuberculosis in patients under anti-tumor necrosis factor treatment.
Retrospective review of two patients with laboratorial evidence of tuberculosis who had bilateral ocular signs and symptoms not attributable to other diseases. Multimodal imaging was analyzed at the time of presentation and after the treatment initiation. The study patients underwent standard treatment for tuberculosis.
Clinical and laboratory findings were consistent with the diagnosis of presumed tuberculosis. Color fundus photograph revealed the presence of multifocal yellowish retinal spots in the study eyes. On fluorescein angiography, the retinal lesions seen on color fundus photograph showed early hypofluorescence with progressive staining of its edges. Occlusive vasculitis with peripheral nonperfusion was also observed in both cases. Spectral domain optical coherence tomography demonstrated increased reflectivity and thickness on the topography of retinitis lesions. After specific antibiotic treatment for tuberculosis, there was complete disappearance of the retinal lesions in all study eyes.
We report two unique cases of bilateral presumed intraocular tuberculosis presenting as multifocal retinitis in patients under biologic agent treatment. Anti-tumor necrosis factor agents may be related to unusual fundus manifestations of tuberculosis.
报告在接受抗肿瘤坏死因子治疗的患者中，眼内结核的独特眼底病变和治疗结果。
回顾性分析了两名实验室证据表明患有结核病且双眼均有眼部症状和体征但不能归因于其他疾病的患者。在就诊时和治疗开始后分析了多模态成像。研究患者接受了结核病的标准治疗。
临床和实验室检查结果与疑似结核病的诊断一致。彩色眼底照片显示研究眼有多发性黄色视网膜斑点。在荧光素血管造影下，彩色眼底照片上的视网膜病变显示早期荧光素减弱，边缘逐渐染色。在两种情况下均观察到闭塞性血管炎伴周边无灌注。频域光相干断层扫描显示视网膜病变的地形图上反射率增加和厚度增加。在针对结核病的特定抗生素治疗后，所有研究眼中的视网膜病变完全消失。
我们报告了两例在接受生物制剂治疗的患者中，双侧疑似眼内结核表现为多灶性视网膜炎的独特病例。抗肿瘤坏死因子药物可能与结核病的不常见眼底表现有关。
