Biswas J, Madhavan H N, Gopal L, Badrinath S S
Medical Research Foundaton, Madras, India.
Retina. 1995;15(6):461-8.
Intraocular tuberculosis is a rare disease. Only approximately 18 cases of microbiologically or histopathologically proven cases of intraocular tuberculosis have been reported.
Between 1984 and 1994, five cases of intraocular tuberculosis were confirmed microbiologically and histopathologically from intraocular specimens in the authors' uveitis clinic. Systemic antitubercular treatment was instituted, along with the treatment for the ocular inflammation.
Clinical presentation included subretinal abscess (two cases), granulomatous anterior uveitis with scleral perforation, an exudative mass in the anterior chamber, and choroidal mass with panuveitis (one case each). Aqueous aspirate in three patients and eviscerated material in the other two showed presence of acid fast bacilli. One globe that required enucleation revealed granulomatous inflammation with caseation necrosis. Two patients showed a significant response to antitubercular therapy, whereas the other three patients eventually required evisceration or enucleation.
Intraocular tuberculosis can have protean manifestations and variable response to systemic antitubercular therapy.
眼内结核是一种罕见疾病。据报道,经微生物学或组织病理学证实的眼内结核病例仅有约18例。
1984年至1994年间,在作者的葡萄膜炎诊所中,经微生物学和组织病理学从眼内标本确诊了5例眼内结核。在进行眼部炎症治疗的同时,开展了全身抗结核治疗。
临床表现包括视网膜下脓肿(2例)、伴有巩膜穿孔的肉芽肿性前葡萄膜炎、前房内渗出性肿物以及伴有全葡萄膜炎的脉络膜肿物(各1例)。3例患者的房水抽吸物及另外2例患者的眼球摘除物显示有抗酸杆菌。1例需要摘除眼球的病例显示有肉芽肿性炎症伴干酪样坏死。2例患者对抗结核治疗有显著反应,而另外3例患者最终需要进行眼球摘除或眼内容物剜除术。
眼内结核可表现出多种症状,对全身抗结核治疗的反应也各不相同。