Document Detail

Complications of presumed ocular tuberculosis.
MedLine Citation:
PMID:  19549099     Owner:  NLM     Status:  In-Process    
PURPOSE: To determine the effect of steroid treatment on visual outcome and ocular complications in patients with presumed ocular tuberculosis.
METHODS: Retrospective review of patients with presumptive ocular tuberculosis. The clinical diagnosis was made based on ocular findings, positive purified protein derivative (PPD) testing of more than 15 mm induration, exclusion of other causes of uveitis and positive ocular response to anti-tuberculous therapy (ATT) within 4 weeks. Group 1 included patients who had received oral prednisone or subtenon injection of triamcinolone acetonide prior to ATT. Group 2 included patients who did not receive corticosteroid therapy prior to administration of ATT.
RESULTS:   Among 500 consecutive new cases of uveitis encountered in 1997-2007 there were 49 (10%) patients with presumed ocular tuberculosis. These comprised 28 (57%) male and 21 (43%) female patients with a mean age of 45 years (range 12-76 years). Four (20%) patients in group 1 had initial visual acuity of 20/40 or better, in comparison to eight (28%) patients in group 2. At 1-year follow-up, six (30%) patients in group 1 had a visual acuity of 20/40 or better compared with 20 (69%) patients in group 2 (p = 0.007). Of 20 eyes (26%) in group 1 that had visual acuity of < 20/50 at 1-year follow up, 14 (70%) eyes developed severe chorioretinal lesion (p = 0.019).
CONCLUSION: Early administration of corticosteroids without anti-tuberculous therapy in presumed ocular tuberculosis may lead to poor visual outcome compared with patients who did not receive corticosteroids prior to presentation. Furthermore, the severity of chorioretinitis lesion in the group of patients given corticosteroid prior to ATT may account for the poor visual outcome.
Issam H Hamade; Khalid F Tabbara
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta ophthalmologica     Volume:  88     ISSN:  1755-3768     ISO Abbreviation:  Acta Ophthalmol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468102     Medline TA:  Acta Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  905-9     Citation Subset:  IM    
Copyright Information:
© 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.
The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia.
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