Pal Sandeep, Patidar Narendra, Tomar Gunjan, Gaikwad Himanshu
Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalaya, Chitrakoot, India.
Consultant and Head of department, Orbit and Oculoplasty, Sadguru Netra Chikitsalaya, Jankikund, District Satna, Chitrakoot, Madhya Pradesh, 210204, India.
J Ophthalmic Inflamm Infect. 2024 Oct 14;14(1):51. doi: 10.1186/s12348-024-00425-x.
Orbital tuberculosis is a rare form of extra pulmonary TB and may arise either by hematogenous route or spread directly from the paranasal sinus. We herein report two cases of orbital TB with a vision threatening complication. Case-1 is a 31-year-old female with a headache, a diminution of vision in the right eye, and pain in ocular movement. On examination, there was no proptosis with RAPD present in right eye and tenderness on palpation. CEMRI revealed a diffuse infiltrating lesion at the orbital apex, suggesting of inflammatory pathology. Case-2 is a 40-year-old male with similar complaints in the left eye, CECT showed edema and swelling in the optic nerve and extraocular muscle of the left eye. A detailed investigation was done, and a diagnosis of orbital tuberculosis was made in both patients. They were started on ATT and oral steroids but lost follow-up initially and due to delayed treatment, it led to irreversible vision loss. A long-term follow-up showed resolution of ocular symptoms with occasional headaches.
眼眶结核是肺外结核的一种罕见形式，可通过血行途径或直接从鼻窦蔓延而来。我们在此报告两例伴有威胁视力并发症的眼眶结核病例。病例1是一名31岁女性，有头痛、右眼视力减退和眼球运动疼痛症状。检查时，右眼无眼球突出但有相对性传入性瞳孔障碍，触诊时有压痛。增强磁共振成像显示眶尖有弥漫性浸润性病变，提示炎症性病变。病例2是一名40岁男性，左眼有类似症状，计算机断层扫描显示左眼视神经和眼外肌有水肿和肿胀。进行了详细检查，两名患者均被诊断为眼眶结核。他们开始接受抗结核治疗和口服类固醇，但最初失去了随访，由于治疗延迟，导致了不可逆的视力丧失。长期随访显示眼部症状缓解，但偶尔仍有头痛。
