Kaya Mahmut, Ömeroglu Şimşek Gökcen, Ucan Eyüp Sabri, Ataş Ferdane, Gündüz Damla, Takar Burça, Saatci Ali Osman
Department of Ophthalmology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Turk Thorac J. 2022 Sep;23(5):322-330. doi: 10.5152/TurkThoracJ.2022.21207.
To evaluate the patients who were treated for intraocular tuberculosis retrospectively and present our findings and share our experience.
This study was a descriptive, cross-sectional, retrospective study. Patients who were followed up with the diagnosis of intraocular tuberculosis in the Ophthalmology and Pulmonary Medicine Departments of Dokuz Eylul University Faculty of Medicine in the last 15 years and received anti-tuberculosis therapy were included.
A total of 16 eyes of 10 patients with a diagnosis of intraocular tuberculosis uveitis who were treated with anti-tuberculosis therapy were included in this study. The mean age was 48.1 [14.6] years (mean [standard deviation]). Four were [40%] male and 6 [60%] were female. Patients with tuberculosis uveitis had bilateral involvement (7 of 10 patients [70%]). Intraocular tuberculosis was presented in 7 eyes of 4 patients with serpiginous like choroiditis, 2 eyes of 2 patients with choroidal tuberculomas, 4 eyes of 2 patients with choroidal tubercles (miliary tuberculosis), and 3 eyes of 2 patients with intermediate uveitis. The mean duration from admission to treat- ment was 18.1 ± 17.4 days (range: 6-56 days). All patients in this study received a 4-drug regimen anti-tuberculosis therapy, Paradoxical reaction occurred in 30% of the patients. Eight patients had systemic steroid therapy and 4 had also topical steroid therapy. The mean length of follow-up was 14.7 months (standard deviation = 15.1, range: 6-48 months). Reactivation of intraocular tuberculosis was not observed in any patients.
High level of suspicion is a must for diagnosing intraocular tuberculosis. A complete ophthalmic examination can be performed in patients with suspected or proven tuberculosis. Early diagnosis and prompt treatment of intraocular tuberculosis can prevent serious complications and loss of vision.
对接受眼内结核治疗的患者进行回顾性评估，展示我们的研究结果并分享经验。
本研究为描述性、横断面、回顾性研究。纳入过去15年在多库兹艾吕尔大学医学院眼科和肺病科确诊为眼内结核并接受抗结核治疗的患者。
本研究纳入了10例诊断为眼内结核性葡萄膜炎且接受抗结核治疗的患者的16只眼。平均年龄为48.1[14.6]岁（均值[标准差]）。男性4例[40%]，女性6例[60%]。结核性葡萄膜炎患者有双侧受累情况（10例患者中的7例[70%]）。4例匐行性脉络膜炎患者的7只眼、2例脉络膜结核瘤患者的2只眼、2例脉络膜结节（粟粒性结核）患者的4只眼以及2例中间葡萄膜炎患者的3只眼出现眼内结核。从入院到治疗的平均时长为18.1±17.4天（范围：6 - 56天）。本研究所有患者均接受四联抗结核治疗方案，30%的患者出现了矛盾反应。8例患者接受了全身类固醇治疗；4例还接受了局部类固醇治疗。平均随访时长为14.7个月（标准差 = 15.1，范围：6 - 48个月）。未观察到任何患者眼内结核复发。
高度怀疑对于诊断眼内结核至关重要。对于疑似或确诊结核的患者可进行全面的眼科检查。眼内结核的早期诊断和及时治疗可预防严重并发症和视力丧失。
