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[眼部结核病]

[Ocular tuberculosis].

作者信息

Ishihara M, Ohno S

机构信息

Department of Ophthalmology, Yokohama City University, School of Medicine.

出版信息

Nihon Rinsho. 1998 Dec;56(12):3157-61.

PMID:9883631
Abstract

The frequency of tuberculous uveitis has extremely decreased in Japan. Anterior granulomatous or non-granulomatous uveitis, chorioretinitis and retinal vasculitis are common ocular manifestations, while tuberculoma, scleritis, keratitis and orbital tuberculosis are rare. The diagnosis of ocular tuberculosis is extremely difficult because ocular tuberculosis tends to be negative in chest x-ray or tuberclin skin test. To diagnose ocular tuberculosis clinically some ophthalmologists recommend subconjunctival tuberculin test or therapeutic isoniazide (INH) test. Recently, for confirmed diagnosis, polymerase chain reaction (PCR) technique has been used to detect mycobacterium in intraocular samples such as aqueous or vitreous humor. The mainstay of treatment is antituberculosis agents. Active retinal vasculitis or tuberculoma are generally responsive to corticosteroid therapy. Although ocular tuberculosis is rare, it must be considered as one of the possible causes of uveitis.

摘要

在日本,结核性葡萄膜炎的发病率已大幅下降。前部肉芽肿性或非肉芽肿性葡萄膜炎、脉络膜视网膜炎和视网膜血管炎是常见的眼部表现,而结核瘤、巩膜炎、角膜炎和眼眶结核则较为罕见。眼部结核的诊断极其困难,因为眼部结核在胸部X光或结核菌素皮肤试验中往往呈阴性。为了临床诊断眼部结核,一些眼科医生推荐结膜下结核菌素试验或治疗性异烟肼(INH)试验。最近,为了确诊,聚合酶链反应(PCR)技术已被用于检测眼内样本(如房水或玻璃体)中的分枝杆菌。治疗的主要手段是抗结核药物。活动性视网膜血管炎或结核瘤通常对皮质类固醇治疗有反应。尽管眼部结核很少见,但它必须被视为葡萄膜炎可能的病因之一。

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