Department of Ophthalmology, Yoshijima Hospital, Hiroshima, Japan.
Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, 734-8551, Japan.
Int Ophthalmol. 2021 Apr;41(4):1427-1436. doi: 10.1007/s10792-021-01718-z. Epub 2021 Jan 21.
This study aimed to elucidate the incidence of ocular involvement among patients with active tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection in a hospital in Japan.
Patients with active TB or NTM infection at Yoshijima Hospital from April 2017 to July 2018 were included in this retrospective study. All patients underwent ophthalmic examinations, including fundus evaluation under pupil dilation, before initiation of antibiotic therapy. Patients with ocular inflammation were regularly followed up by ophthalmologists.
In total, 101 patients with active TB and 27 patients with active NTM infection underwent ophthalmic examinations during the study period. Seven patients with TB (6.9%) had ocular inflammation; four had bilateral involvement. In these seven patients, ocular inflammation comprised anterior uveitis (n = 2), intermediate uveitis (n = 1), posterior uveitis (n = 4). Choroidal tubercles were observed in two patients with posterior uveitis. Female sex was associated with higher incidence of ocular inflammation among patients with TB. Conversely, no patients with NTM infection had ocular inflammation.
Ocular inflammation was present in approximately 7% of patients with active TB. Although TB choroiditis is presumed to be rare in Japan, approximately 30% of the patients with ocular inflammation exhibited choroidal lesions in this study. In contrast, no ocular inflammation was observed among patients with systemic NTM infection.
本研究旨在阐明日本某医院活动性肺结核（TB）或非结核分枝杆菌（NTM）感染患者眼部受累的发生率。
本回顾性研究纳入了 2017 年 4 月至 2018 年 7 月在吉岛医院接受治疗的活动性 TB 或 NTM 感染患者。所有患者在开始抗生素治疗前均接受了眼部检查，包括瞳孔扩张下眼底评估。有眼部炎症的患者由眼科医生定期随访。
在研究期间，共有 101 例活动性 TB 患者和 27 例活动性 NTM 感染患者接受了眼科检查。7 例 TB（6.9%）患者存在眼部炎症，其中 4 例为双眼受累。在这 7 例患者中，眼部炎症包括前葡萄膜炎（n=2）、中间葡萄膜炎（n=1）、后葡萄膜炎（n=4）。2 例后葡萄膜炎患者观察到脉络膜结核。TB 患者中，女性眼部炎症发生率较高。相反，无 NTM 感染患者出现眼部炎症。
活动性 TB 患者中约有 7%存在眼部炎症。尽管日本推测 TB 脉络膜炎罕见，但本研究中约 30%的眼部炎症患者存在脉络膜病变。相比之下，系统 NTM 感染患者未观察到眼部炎症。
