Agarwal Manisha, Paul Lagan, Gupta Chanda, Rani Padmaja Kumari
Department of Vitreoretinal Services, Dr Shroff's Charity Eye Hospital, New Delhi, India.
Vitreoretinal Department, LV Prasad Eye Institute, Hyderabad, India.
BMJ Case Rep. 2019 Jan 14;12(1):bcr-2018-227194. doi: 10.1136/bcr-2018-227194.
Tubercular uveitis is a common manifestation of tuberculosis (TB) in TB-endemic countries. Due to lack of gold standard diagnostic tests for confirming intraocular TB, it is often either underdiagnosed or rarely over diagnosed. We report a case of a 28-year-old woman with diminution of vision in the left eye. She was started on antitubercular treatment (ATT) and steroids but she did not comply with the treatment. She developed progressive painful loss of vision consequently and was treated with vitrectomy and silicone oil tamponade. After a complete course of ATT, she recovered, salvaging of eye and restoration of some vision was possible. Mycobacterium tuberculosis is rarely demonstrated in the ocular fluid samples of the suspected cases of TB due to the paucibacillary nature of the disease. A vitreous sample can be obtained from these patients. Surgical intervention in the form of vitrectomy and silicone oil tamponade can help in avoiding enucleation/evisceration.
在结核病流行国家，结核性葡萄膜炎是结核病的常见表现。由于缺乏用于确诊眼内结核的金标准诊断测试，该病常常要么诊断不足，要么很少被过度诊断。我们报告一例28岁女性，其左眼视力下降。她开始接受抗结核治疗（ATT）和类固醇治疗，但未坚持治疗。结果，她出现了进行性疼痛性视力丧失，并接受了玻璃体切除术和硅油填充治疗。经过完整疗程的ATT后，她康复了，保住了眼睛并恢复了部分视力。由于该病细菌数量少的特性，在疑似结核病例的眼液样本中很少能检测到结核分枝杆菌。可以从这些患者身上获取玻璃体样本。玻璃体切除术和硅油填充形式的手术干预有助于避免眼球摘除/眼内容剜出术。
