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眼部结核病诊断的当前概念:一篇叙述性综述。

Current concepts in the diagnosis of ocular tuberculosis: A narrative review.

作者信息

Konana Vinaya Kumar, Babu Kalpana

机构信息

Department of Vitreoretinal Services, Vittala International Institute of Ophthalmology, Bengaluru, Karnataka, India.

Department of Uveitis and Ocular Inflammation, Prabha Eye Clinic and Research Centre, Vittala International Institute of Ophthalmology, Bengaluru, Karnataka, India.

出版信息

Taiwan J Ophthalmol. 2025 Jun 10;15(2):203-211. doi: 10.4103/tjo.TJO-D-24-00115. eCollection 2025 Apr-Jun.

Abstract

Ocular tuberculosis (OTB) is one of the extrapulmonary manifestations caused by (Mtb). If untreated, it can result in poor visual prognosis. Prompt diagnosis of OTB is met with challenges. The gold standard for the diagnosis of OTB is the direct demonstration of the Mtb in ocular tissues or ocular fluids either by Ziehl-Neelsen Stain, culture or molecular diagnostic techniques such as polymerase chain reaction. This is onerous owing to the paucibacillary nature of the disease, small quantity of samples, and low sensitivity and specificity of molecular diagnostic tests. Thus, one needs to rely on indirect evidences to make a diagnosis. Hence, most often, the diagnosis of OTB is presumed based on the geography the patient hails from and indirect laboratory evidences suggestive of TB. In this narrative review, we review clinical, laboratory, and radiology markers which aid in the diagnosis of OTB and outline the current concepts in the diagnosis of OTB.

摘要

眼部结核病(OTB)是由结核分枝杆菌(Mtb)引起的肺外表现之一。若不治疗,可导致视力预后不良。OTB的及时诊断面临挑战。OTB诊断的金标准是通过萋-尼染色、培养或聚合酶链反应等分子诊断技术在眼组织或眼液中直接显示Mtb。由于该疾病菌量少、样本量小以及分子诊断试验的敏感性和特异性低,这一过程很繁琐。因此,需要依靠间接证据来进行诊断。所以,大多数情况下,OTB的诊断是根据患者来自的地区以及提示结核病的间接实验室证据来推测的。在这篇叙述性综述中,我们回顾了有助于OTB诊断的临床、实验室和放射学标志物,并概述了OTB诊断的当前概念。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8206/12204663/3a36becd8b61/TJO-15-203-g001.jpg

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