| Abstrakt: |
Introduction: Recently, tuberculosis (TB) has reemerged and raised the possibility of increasing prevalence of ocular tuberculosis. Tuberculosis with ocular manifestation may involve various segments of the eye and cause severe visual loss if not treated properly. Ocular tuberculosis is mostly secondary from the systemic sources and rarely acts as the portal of entry. Objectives: To report the clinical presentations of presumed ocular tuberculosis and the results of anti tuberculosis treatment in immunocompetent patients. Methodology: An observational case series were conducted involving immunocompetent patients who were confirmed, presumed or probable case of ocular tuberculosis seen in Hospital Universiti Sains Malaysia (HUSM) from January 2000 to December 2004. Their demographic data, clinical features, investigations to confirm the diagnosis as well as their visual outcome were documented. Results: Eight cases of ocular tuberculosis were included (involving 12 eyes). All were immunocompetent patients. The most common complaint was reduced vision (92%), followed by eye pain (41.7%) and eye redness (33.3%). Four eyes presented with good visual acuity (6/6 - 6/12). Granulomatous anterior uveitis (75%) is the most common ocular findings, followed by posterior uveitis (58%), papilitis (8%), choroidal tubercle (8%), panophtalmitis (8%) and masquerade syndrome mimicking ocular tumor (8%) are also noted in these patients. Three patients presented with systemic symptoms and only 2 patients had history of contact with tuberculosis patient. Tuberculin skin test was positive in 7 patients. Based on the clinical findings and investigation results, 6 cases were defined as presumed ocular tuberculosis and the remaining 2 patients as probable cases. Six eyes have improvement of vision post treatment with anti-tuberculosis regime, visual acuity in 3 eyes remains the same and another 3 eyes had worsening of vision. Conclusion: Ocular tuberculosis is still a challenge to an ophthalmologist due to its diversified manifestation, difficulties in diagnosing and dilemma in treatment. However, high index of suspicion and early intervention will be able to provide a better visual outcome in most of our patients. [ABSTRACT FROM AUTHOR] |
