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Ocular Tuberculosis

Bhagya Sudheer, Manisha Agarwal, Deepa Sharma, Ravi Mehta, Kalpana Babu
PURPOSE: To report our experience of using Endobronchial ultrasound-guided transbronchial lymph node aspiration (EBUS-TBNA) in assessing the etiology in uveitis from two tertiary eye-care centers in India. MATERIALS & METHODS: Retrospective interventional case series. RESULTS: A total of 99 patients of uveitis who underwent EBUS-TBNA were included in the study. Mycobacterium tuberculosis (MTb) was detected on culture in 5 cases, 3 cases by polymerase chain reaction and caseating granulomas in 25 cases...
March 15, 2018: Ocular Immunology and Inflammation
Andreea Nicolcescu, Carmen Mocanu, Loredana Dinu, Andrei Olaru, Mara Ionete, Dima Alin Stefanescu
Introduction. Eales disease is an idiopathic peripheral vascular occlusive disease characterized by inflammation, ischemia, and retinal neovascularization and is hallmarked by recurrent vitreous hemorrhages and vision loss. Case report. We present a case of a 48-year-old female with recurrent floaters and decreased vision in her right eye. The onset of symptoms was in 2007 when a diagnose of retinal vasculitis was made. She had no accompanying systemic signs and symptoms and no history of ocular trauma or previous tuberculosis infection...
April 2017: Romanian Journal of Ophthalmology
Anca Pantalon, Emanuela Găman, Iustina-Silvia Crețu-Silivestru, Ciprian Danielescu
We present the case of a patient who was diagnosed by chance with macular hypopyon during a conventional interdisciplinary examination. The clinical context and the association of a systemic disease, such as uncontrolled type 1 diabetes, rendered further investigations in this patient. Due to his immunocompromised status, etiology such as ocular fungi, lymphomas, tuberculosis was taken into account. Thorough complex investigations oriented the diagnosis towards ocular tuberculosis involvement.
April 2017: Romanian Journal of Ophthalmology
Reema Bansal, Amod Gupta, Ritesh Agarwal, Mohit Dogra, Garvit Bhutani, Vishali Gupta, M R Dogra, Deeksha Katoch, Ashutosh Nath Aggarwal, Aman Sharma, Raje Nijhawan, Ritambara Nada, Uma Nahar Saikia, Pranab Dey, Digambar Behera
PURPOSE: To report the role of CT chest and cytology in suspected tubercular and sarcoid uveitis. METHODS: This is a retrospective, interventional case series of 376 uveitis patients with suspected ocular tuberculosis (TB)/sarcoidosis seen between January 2010 and April 2015 at the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. All underwent CT chest, and had following inclusion criteria: (1) Presence of active granulomatous anterior/intermediate/posterior uveitis or panuveitis; (2) a documented tuberculin skin test/QuantiFERON-TB Gold test; (3) all other causes of infectious/non-infectious uveitis ruled out...
February 8, 2018: Ocular Immunology and Inflammation
Murat Hasanreisoglu, Gokcen Gulpinar Ikiz, Zeynep Aktas, Sengul Ozdek
INTRODUCTION: Tuberculosis-associated uveitis remains a diagnostic and therapeutic challenge. After diagnosis of tuberculosis and initiation of anti-tuberculosis therapy for tuberculosis uveitis, the clinical responses are favorable. However, at 4-6 weeks of the therapy, there commonly occurs paradoxical deterioration due to an increase in inflammation which is often accompanied by cystoid macular edema. Thus, adjuvant administration of anti-inflammatory regimen should be considered. For this purpose, systemic and periocular steroids, systemic and intravitreal immunosuppressive agents have been tested...
January 29, 2018: International Ophthalmology
Manisha Agarwal, Ankita Shrivastav, Abdul Waris
BACKGROUND: Tubercular vasculitis is an important manifestation of ocular tuberculosis and this report highlights the mimicking nature of the disease with frosted branch angiitis. RESULTS: A patient presented with a severe form of retinal vasculitis in both eyes and a branch retinal vein occlusion in the left eye. He had a positive tuberculin skin test (TST) and a raised erythrocyte sedimentation rate (ESR) and serum angiotensin-converting enzyme (ACE) levels. Radiological investigations revealed a sub-pleural nodule and mediastinal lymph nodes, which on histopathological evaluation confirmed a granulomatous etiology...
January 22, 2018: Journal of Ophthalmic Inflammation and Infection
Ranju Kharel Sitaula, M K Janani, H N Madhavan, Jyotirmay Biswas
BACKGROUND: Polymerase chain reaction (PCR) analysis is an important tool in the diagnosis of infectious uveitis. A retrospective, interventional study of PCR analysis of ocular fluid in suspected infectious uveitis cases between January 2014 to July 2016 was done. Nested, real-time and broad range PCR was performed for detection of the genome of Mycobacterium tuberculosis, herpes virus family, Chikungunya virus, Toxoplasma gondii, fungus, eubacterium and propionibacterium acne. RESULTS: Total of 100 cases included, mean age was 39...
January 10, 2018: Journal of Ophthalmic Inflammation and Infection
Aniruddha Agarwal, Rupesh Agrawal, Dinesh Visva Gunasekaran, Dhananjay Raje, Bhaskar Gupta, Kanika Aggarwal, Somasheila L Murthy, Mark Westcott, Soon Phaik Chee, Peter Mccluskey, Ho Su Ling, Stephen Teoh, Luca Cimino, Jyotirmay Biswas, Shishir Narain, Manisha Agarwal, Padmamalini Mahendradas, Moncef Khairallah, Nicholas Jones, Ilknur Tugal-Tutkun, Kalpana Babu, Soumayava Basu, Ester Carreño, Richard Lee, Hassan Al-Dhibi, Bahram Bodaghi, Alessandro Invernizzi, Debra A Goldstein, Carl P Herbort, Talin Barisani-Asenbauer, Julio J González-López, Sofia Androudi, Reema Bansal, Bruttendu Moharana, Sarakshi Mahajan, Simona Esposti, Anastasia Tasiopoulou, Sengal Nadarajah, Mamta Agarwal, Sharanya Abraham, Ruchi Vala, Ramandeep Singh, Aman Sharma, Kusum Sharma, Manfred Zierhut, Onn Min Kon, Emmett Cunningham, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta
PURPOSE: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. METHODS: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. RESULTS: 59 (6.13%) of COTS-1 underwent PCR analysis...
December 20, 2017: Ocular Immunology and Inflammation
Rupesh Agrawal, Robert Grant, Bhaskar Gupta, Dinesh Visva Gunasekeran, Julio J Gonzalez-Lopez, Peter K F Addison, Mark Westcott, Carlos E Pavesio
BACKGROUND: To evaluate the contribution made to the diagnostic work-up for patients with suspected ocular tuberculosis (TB) by QuantiFERON-TB Gold In-Tube (QFT) tests using latent class analysis model. METHODS: A single centre retrospective cohort study. A Bayesian latent class model was constructed on the basis of demographics, phenotypes and test results from patients attending a tertiary referral center in the UK. This estimated the probability of ocular TB for each patient in two versions, first with and then without QFT...
December 8, 2017: BMC Ophthalmology
Erika Marie Damato, Sarah Dawson, Xiaoxuan Liu, Chandoshi Mukherjee, John Horsburgh, Alastair K Denniston, Edward Moran, Martin Dedicoat, Philip Ian Murray
BACKGROUND: Uveitis involving the posterior segment is a significant and potentially blinding condition. The diagnosis and treatment of patients with uveitis associated with tuberculosis remains controversial, and commonly, patients are systemically well. Use of the interferon-gamma release assays has added to the controversy, as the significance of a positive test may be uncertain. We aim to report the outcomes of anti-tuberculous treatment in a cohort of patients treated in Birmingham, for presumed "ocular tuberculosis", based on clinical findings, systemic assessment and specific testing for tuberculosis...
December 4, 2017: Journal of Ophthalmic Inflammation and Infection
Soumyava Basu, Benjamin J Fowler, Nagaraj Kerur, Kristine B Arnvig, Narsing A Rao
The molecular basis of intraocular tuberculosis (TB) is not well understood. In this study, we investigated the role of two constituents of viable Mycobacterium tuberculosis - Early Secreted Antigenic Target-6 (ESAT-6), and mycobacterial RNA- in inflammasome activation in the retinal pigment epithelium (RPE), a key site of inflammation in intraocular TB. We found that ESAT-6 induced caspase-1 activation and inflammasome priming in mouse RPE cells, substantially more in wild-type than in Tlr2/3/4/7/9-/- , Myd88-/- or Nlrp3-/- RPE cells...
January 2018: Microbial Pathogenesis
Avinash Pathengay, Bhavik Panchal, Himadri Choudhury, Soumyava Basu, Nidhi Relhan, Harry W Flynn
Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculosis...
September 2017: American Journal of Ophthalmology Case Reports
Rupesh Agrawal, Dinesh Visva Gunasekeran, Robert Grant, Aniruddha Agarwal, Onn Min Kon, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta
Importance: Eradication of systemic tuberculosis (TB) has been limited by neglected populations and the HIV pandemic. Whereas ocular TB often presents as uveitis without any prior evidence of systemic TB, the existing uncertainty in the diagnosis of TB uveitis may perpetuate missed opportunities to address systemic TB. Objective: To examine the clinical features of TB uveitis and the associations with response to antitubercular therapy (ATT). Design, Setting, and Participants: This retrospective multinational cohort study included patients from 25 ophthalmology referral centers diagnosed with TB uveitis and treated with ATT from January 1, 2004, through December 31, 2014, with a minimum follow-up of 1 year...
December 1, 2017: JAMA Ophthalmology
Lin Ho Wong, Endean Tan
Oculogyric crisis (OGC), frequently caused by medications such as antiemetics, antidepressants, and anti-epileptics, is an acute dystonic reaction of the ocular muscles. It consists of wide-staring gaze (lasting variably from seconds to minutes), seizures, and a widely-opened mouth. To date, there have been no reports of anti-tuberculosis medications such as rifampicin, isoniazid, pyrazinamide or ethambutol inducing OGC. It is of utmost importance to recognize this adverse reaction, which could be incorrectly diagnosed as an anaphylactic-like reaction...
2017: International Medical Case Reports Journal
M Shahidatul-Adha, E Zunaina, A T Liza-Sharmini, W H Wan-Hazabbah, I Shatriah, I Mohtar, Y Azhany, H Adil
INTRODUCTION: Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by Mycobacterium tuberculosis, a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated. PURPOSE: To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM). METHOD: A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016...
December 2017: Annals of Medicine and Surgery
K Sharma, A Gupta, M Sharma, A Sharma, R Singh, K Aggarwal, R Bansal, A Thakur, S Prakash, V Gupta
PurposeTimely diagnosis of intraocular tuberculosis (IOTB) along with detection of drug resistance can save many eyes from visual impairment. With the growing incidence of IOTB and rising drug resistance, a reliable diagnostic platform for simultaneous detection of the agent and mutated gene is urgently needed. The MTBDRplus assay was evaluated directly on vitreous fluid samples for the same.Patients and methodsIn a prospective study, The MTBDRplus assay was performed on 127 vitreous fluid samples (77 'study group' comprising cases of presumed ocular tuberculosis and 50 'control group' cases of disease controls (n=25) and non-uveitic controls (n=25))...
October 20, 2017: Eye
Koushik Tripathy
No abstract text is available yet for this article.
October 11, 2017: Ocular Immunology and Inflammation
Sushmita Kaushik, Ramandeep Singh, Atul Arora, Gunjan Joshi, Kusum Sharma, Basavraj Tigari
Acute angle closure is usually thought to be secondary to pupillary block, which is relieved by laser iridotomy. Anterior rotation of the ciliary body at the scleral spur following development of an inflammatory ciliochoroidal detachment may result in a presentation of acute angle closure. It is imperative to recognize this condition correctly, because the management is with cycloplegics and anti-inflammatory drugs, which is diametrically opposite to the treatment of primary angle closure. More importantly, it has been reported as a consequence of serious systemic disease such as HIV infection and Vogt Koyanagi Harada (VKH) syndrome...
December 2017: Journal of Glaucoma
Kristina L Bajema, Kaivon Pakzad-Vaezi, Thomas Hawn, Kathryn L Pepple
BACKGROUND: The study aims to report the association between successful uveitis control following anti-tuberculous therapy (ATT) for uveitis associated with a positive tuberculosis (TB) screening test in a low endemic setting. A retrospective chart review of cases between 2010 and 2017 at a tertiary uveitis referral center in the United States of America was conducted. Subjects with any form of uveitis, a positive TB interferon-gamma release assay or tuberculin skin test, and negative evaluation for other causes of uveitis were included...
October 4, 2017: Journal of Ophthalmic Inflammation and Infection
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