●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features ...●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.展开更多
Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,mos...Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.展开更多
We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study ...We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.展开更多
Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these co...Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these conditions.Methods This retrospective,case-control study examined consecutively enrolled patients with active Tb-SLC or SC.Patients underwent comprehensive ocular examinations and imaging（OCT,color fundus photography,autofluorescence imaging,fluorescein angiography,and indocyanine green angiography）.Findings were examined and compared between eyes with SC and Tb-SLC.Results Nine patients with active Tb-SLC（14 eyes） and 8 with active SC（12 eyes） were included.The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group： vitreal hyper-reflective spots [5 Tb-SLC eyes（36%）,no SC eyes：P = 0.02],intraretinal edema [11 Tb-SLC eyes（79%）,3 SC eyes（25%）：P = 0.01],sub-retinal pigment epithelium（RPE） drusenoid deposits [11 Tb-SLC eyes（79%）,2 SC eyes（17%）：P 〈 0.01],and choroidal granulomas [8 Tb-SLC eyes（57%）,2 SC eyes（17%）：P = 0.03].A hyporeflective,wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes（36%）,9 SC eyes（75%）：P = 0.045] than in the Tb-SLC group.The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection,outer retinal tabulation,and choriocapillaris point-like hyper-reflection.Conclusion Vitreal hyper-reflective spots,intraretinal fluid,sub-RPE drusenoid deposits,and choroidal granulomas on OCT images may indicate Tb-SLC.Additionally,a hyporeflective,wedge-shaped band may indicate SC.Therefore,OCT is likely helpful in differentiating between Tb-SLC and SC.展开更多
Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degene...Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degeneration （AMD）. Methods： In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups： 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal （Ivr） injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization. Results： Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy （P〈0.05）. The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients （Z=-2.844, P=0.009）. Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy （P〈0.05）, and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later （P〉0.05）. Conclusions： IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.展开更多
Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional...Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population;1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.展开更多
Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). ...Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). Methods: Eight eyes of 8 patients treated with intravitreal anti-VEGF and posterior sub-tenon injection of Triamcinolone Acetonide (TA) for subfoveal or juxtafoveal CNV associated with MC were retrospectively reviewed. Best corrected visual acuity (BCVA), results of fundus fluorescein angiography (FFA)/indocyanine green angiography (ICGA), optical coherence tomography (OCT) at baseline and 3, 6 months after treatment were compared. Results: All of the 8 patients showed significant improvement in BCVA at 3 and 6 months after treatment (P < 0.05). FFA/ICGA showed decrease or cessation of inflammation in 8 patients (100%). 7 patients (87.5%) had no significant active leakage while 1 patient (12.5%) had persistent leakage from the neovascular lesion at 3-month follow up. 6 months after treatment, no recurrence of inflammation occurred and no active leakage in all 8 patients. OCT showed reduced CNV area and alleviated edema. There are no severe treatment-related side effects expect slight eye pain during infusion in one patient. Intraocular pressure was all normal in follow up. Conclusion: Although the follow-up time and the number of patients in this study were limited, the use of intravitreal anti-VEGF combined with sub-tenon injection of TA was associated with improvement of visual acuity in patients with CNV secondary to MC. Further studies including a greater number of patients with longer follow up time are needed.展开更多
AIM:To determine the spectrum of uveitis,causes of visual loss in systemic tuberculosis(TB),role of investigations and outcome after anti-TB therapy(ATT).METHODS:A retrospective study was conducted on 250 patients wit...AIM:To determine the spectrum of uveitis,causes of visual loss in systemic tuberculosis(TB),role of investigations and outcome after anti-TB therapy(ATT).METHODS:A retrospective study was conducted on 250 patients with systemic TB at a referral center in Chennai,South India from April 2016 to May 2019.Systemic workup comprised of Mantoux,chest X-ray,polymerase chain reaction(PCR)and QuantiFERON(QFT)TB Gold.Aqueous humor analysis by nested PCR or real time PCR(RT-PCR)and ancillary ophthalmic investigations such as fundus fluorescein angiography,optical coherence tomography were performed.RESULTS:Multifocal choroiditis and vasculitis were the most common manifestations(39%and 24%respectively)together accounting for 61%of cases and they had a higher risk of recurrence(3%).Pulmonary tuberculosis(PTB)was more frequently associated with uveitis(18%).Among those with extra-pulmonary tuberculosis(EPTB),uveitis occured in miliary TB(2%),bone(1%)and abdominal TB(1%).Complications such as cystoid macular edema,choroidal neovascular membranes and macular scarring caused visual loss.Aqueous humor analysis detected mycobacterium TB antigen.Collectively,systemic investigations such as chest X-ray,Mantoux test and those performed on blood samples such as PCR and QFT were positive in 39%of patients.In inconclusive patients,nested PCR and/or RT-PCR were done on aqueous humor samples and were diagnostic in 96%.A combination of tests was diagnostic in 92%.ATT in isolation in 71%and combined with corticosteroids in 29%was used for treatment of which signs of resolution and improvement in vision started as early as 6wk in those who were started immediately on corticosteroids and ATT and longer than 3mo in those on ATT alone.Prompt treatment with ATT and corticosteroids improved vision in 23%of our patients within 2mo.Vitritis with choroiditis causes cystoid macular oedema and requires longer duration of ATT.Vision improved in 69%.Complete resolution occurred in 75%and worsening in 12%.CONCLUSION:A combination of investigations guided 展开更多
TUBERCULOSIS （TB） remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis...TUBERCULOSIS （TB） remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis （M. tuberculosis）.展开更多
基金Supported by the National Natural Science Foundation of China(No.82171073No.82101147).
文摘●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.
文摘Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.
文摘We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.
基金supported by the National Natural Science Foundation of China[No.81400422 and 81271034]2015 Outstanding Young Scholar of Beijing[2015000021223ZK22]+1 种基金Key Discipline Leading Plan in Beijing Institute of Ophthalmology[201503]Capital’s Funds for Health Improvement and Research[2018-2-1081]
文摘Objective To investigate optical coherence tomography（OCT） characteristics of tuberculous serpiginous-like choroiditis（Tb-SLC） and serpiginous choroiditis（SC） and to perform OCT to differentiate between these conditions.Methods This retrospective,case-control study examined consecutively enrolled patients with active Tb-SLC or SC.Patients underwent comprehensive ocular examinations and imaging（OCT,color fundus photography,autofluorescence imaging,fluorescein angiography,and indocyanine green angiography）.Findings were examined and compared between eyes with SC and Tb-SLC.Results Nine patients with active Tb-SLC（14 eyes） and 8 with active SC（12 eyes） were included.The following OCT findings were observed significantly more often in the Tb-SLC group than in the SC group： vitreal hyper-reflective spots [5 Tb-SLC eyes（36%）,no SC eyes：P = 0.02],intraretinal edema [11 Tb-SLC eyes（79%）,3 SC eyes（25%）：P = 0.01],sub-retinal pigment epithelium（RPE） drusenoid deposits [11 Tb-SLC eyes（79%）,2 SC eyes（17%）：P 〈 0.01],and choroidal granulomas [8 Tb-SLC eyes（57%）,2 SC eyes（17%）：P = 0.03].A hyporeflective,wedge-shaped band was observed more often in the SC group [5 Tb-SLC eyes（36%）,9 SC eyes（75%）：P = 0.045] than in the Tb-SLC group.The incidence of other OCT signs did not differ between the groups and included outer nuclear layer hyper-reflection,outer retinal tabulation,and choriocapillaris point-like hyper-reflection.Conclusion Vitreal hyper-reflective spots,intraretinal fluid,sub-RPE drusenoid deposits,and choroidal granulomas on OCT images may indicate Tb-SLC.Additionally,a hyporeflective,wedge-shaped band may indicate SC.Therefore,OCT is likely helpful in differentiating between Tb-SLC and SC.
基金Project supported by the National Natural Science Foundation of China(No.81500760)
文摘Objective： To evaluate the effect of anti-vascular endothelial growth factor （VEGF） on juxtafoveal choroidal neovascularization （CNV） secondary to multifocal choroiditis （MFC） and wet age-related macular degeneration （AMD）. Methods： In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups： 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal （Ivr） injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization. Results： Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy （P〈0.05）. The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients （Z=-2.844, P=0.009）. Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy （P〈0.05）, and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later （P〉0.05）. Conclusions： IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.
文摘Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population;1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.
文摘Purpose: To evaluate the short-term efficacy of intravitreal anti-VEGF (Lucentis) and sub-tenon injection of triamcinolone acetonide for choroidal neovascularization (CNV) associated with multifocal choroiditis (MC). Methods: Eight eyes of 8 patients treated with intravitreal anti-VEGF and posterior sub-tenon injection of Triamcinolone Acetonide (TA) for subfoveal or juxtafoveal CNV associated with MC were retrospectively reviewed. Best corrected visual acuity (BCVA), results of fundus fluorescein angiography (FFA)/indocyanine green angiography (ICGA), optical coherence tomography (OCT) at baseline and 3, 6 months after treatment were compared. Results: All of the 8 patients showed significant improvement in BCVA at 3 and 6 months after treatment (P < 0.05). FFA/ICGA showed decrease or cessation of inflammation in 8 patients (100%). 7 patients (87.5%) had no significant active leakage while 1 patient (12.5%) had persistent leakage from the neovascular lesion at 3-month follow up. 6 months after treatment, no recurrence of inflammation occurred and no active leakage in all 8 patients. OCT showed reduced CNV area and alleviated edema. There are no severe treatment-related side effects expect slight eye pain during infusion in one patient. Intraocular pressure was all normal in follow up. Conclusion: Although the follow-up time and the number of patients in this study were limited, the use of intravitreal anti-VEGF combined with sub-tenon injection of TA was associated with improvement of visual acuity in patients with CNV secondary to MC. Further studies including a greater number of patients with longer follow up time are needed.
文摘AIM:To determine the spectrum of uveitis,causes of visual loss in systemic tuberculosis(TB),role of investigations and outcome after anti-TB therapy(ATT).METHODS:A retrospective study was conducted on 250 patients with systemic TB at a referral center in Chennai,South India from April 2016 to May 2019.Systemic workup comprised of Mantoux,chest X-ray,polymerase chain reaction(PCR)and QuantiFERON(QFT)TB Gold.Aqueous humor analysis by nested PCR or real time PCR(RT-PCR)and ancillary ophthalmic investigations such as fundus fluorescein angiography,optical coherence tomography were performed.RESULTS:Multifocal choroiditis and vasculitis were the most common manifestations(39%and 24%respectively)together accounting for 61%of cases and they had a higher risk of recurrence(3%).Pulmonary tuberculosis(PTB)was more frequently associated with uveitis(18%).Among those with extra-pulmonary tuberculosis(EPTB),uveitis occured in miliary TB(2%),bone(1%)and abdominal TB(1%).Complications such as cystoid macular edema,choroidal neovascular membranes and macular scarring caused visual loss.Aqueous humor analysis detected mycobacterium TB antigen.Collectively,systemic investigations such as chest X-ray,Mantoux test and those performed on blood samples such as PCR and QFT were positive in 39%of patients.In inconclusive patients,nested PCR and/or RT-PCR were done on aqueous humor samples and were diagnostic in 96%.A combination of tests was diagnostic in 92%.ATT in isolation in 71%and combined with corticosteroids in 29%was used for treatment of which signs of resolution and improvement in vision started as early as 6wk in those who were started immediately on corticosteroids and ATT and longer than 3mo in those on ATT alone.Prompt treatment with ATT and corticosteroids improved vision in 23%of our patients within 2mo.Vitritis with choroiditis causes cystoid macular oedema and requires longer duration of ATT.Vision improved in 69%.Complete resolution occurred in 75%and worsening in 12%.CONCLUSION:A combination of investigations guided
文摘TUBERCULOSIS （TB） remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis （M. tuberculosis）.
