Presumed tuberculomas of the choroid
Yıl 2014,
Cilt: 4 Sayı: 1, 36 - 40, 27.07.2014
Aalia Sufi
Sabia Rashid
Samia Rashid
Öz
Choroidal granuloma is a rare presentation of tuberculosis especially in immunocompetent individuals. We present a case of a young female with marked decrease in visual acuity of the left eye and a choroidal lesion on fundus examination however with no systemic manifestation of tuberculosis except a positive Mantoux test. A presumptive diagnosis of tuberculosis was made and the patient was put on anti tubercular treatment with corticosteroids to which she showed drastic improvement. Thus it is important to have a high index of suspicion for the diagnosis and treatment in these eyes.
Kaynakça
- Samson MC, Foster CS. Tuberculosis. In: Foster CS, VitaleAT (eds). Diagnosis and Treatment of Uveitis. WB Saunders Company: Philadelphia, 2002, pp 264–272.
- Gupta V, Gupta A, Rao NA. Intraocular tuberculosis: An update. Surv Ophthalmol 2007;52:561-87.
- Shimakawa M. Choroidal tuberculoma in a patient with acquired immunodeficiency syndrome. J Jpn Ophthalmol Soc 2000;104:437-41.
- DiLoreto Jr DA, Rao NA. Solitary nonreactive choroidal tuberculoma in a patient with acquired immune deficiency syndrome. Am J Ophthalmol 2001;131:138-40.
- Barondes MJ, Sponsel WE, Stevens TS, Plotnik RD: Tuberculous choroiditis diagnosed by chorioretinal endobiopsy . Am J Ophthalmol 112 460-461, 1991.
- Helm CJ, Holland GN. Ocular tuberculosis. Surv Ophthalmol 1993;38:229-56.
- Rosen PH, Spalton DJ, Graham EM. Intraocular tuberculosis. Eye 1990;4:486-92.
- Sarvananthan N, Wiselka M, Bibby K. Intraocular tuberculosis without detectable systemic infection. Arch Ophthalmol 1998;116:1386-8.
- Cimino L, Herbort CP, Aldigeri R, Salvarani C, Boiardi L. Tuberculous uveitis: A resurgent and underdiagnosed disease. Int Ophthalmol 2009 Apr;29(2):67-74. Epub 2007 May 8.
- Al-Mezaine HS, Al-Muammar A, Kangave D, Abu El-Asrar AM. Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. Int Ophthalmol 2008;28:413-23
- Biswas J, Shome D: Choroidal tubercles in disseminated tuberculosis diagnosed by the polymerase chain reaction of aqueous humor : A case report and review of the literature . Ocul Immunol Inflamm 10 293-298, 2002.
- Mehta S, Chauhan V, Hastak S: Choroidal tubercles in neurotuberculosis : Prevalence and significance . Ocul Immunol Inflamm 14 341-345, 2006.
- Gupta V, Gupta A, Sachdev N: Successful management of tubercular subretinal granulomas . Ocul Immunol Inflamm 14 35-40, 2006.
- Parikh R, Parikh S, Arun E, Thomas R: Likelihood ratios: clinical application in day-to-day practice . Ind J Ophthalmol 57 217-221, 2009.
- Gupta A, Gupta V. Tubercular posterior uveitis. Int Ophthalmol Clin 2005;45(2):71-88.
- Albini TA, Karakousis PC, Rao NA. Interferon-gamma release assays in the diagnosis of tuberculous uveitis. Am J Ophthalmol 2008;146:486-8.
- Kurup SK, Buggage RR, Clarke GL, Ursea R, Lim WK, Nussenblatt RB. Gamma interferon assay as an alternative to PPD skin testing in selected patients with granulomatous intraocular inflammatory disease. Can J Ophthalmol 2006;41(6):737-40.
- Gupta V, Arora S, Gupta A, Ram J, Bambery P, Sehgal S. Management of presumed intraocular tuberculosis: Possible role of the polymerase chain reaction. Acta Ophthalmol Scand 1998;35:237-9.
Koroidin Tüberkülom Öntanısı
Yıl 2014,
Cilt: 4 Sayı: 1, 36 - 40, 27.07.2014
Aalia Sufi
Sabia Rashid
Samia Rashid
Öz
Koroidal granülom özellikle immunkompetan bireylerde tüberkülozun nadir bir prezantasyonudur. Pozitif PPD testi dışında tüberkülozun klinik manifestasyonu olmayan fundus muayenesinde sol gözde koroidal lezyon ve sol gözde görmede belirgin azalma saptanan genç bayan hasta sunulmuştur. Tüberküloz öntanısı ile kortikosteroidin de bulunduğu antitüberküloz tedavi başlandı ve dramatik cevap alındı. Bu şekilde olan gözlerde tanı ve tedavide yüksek şüpheye sahip olmak önemlidir.
Kaynakça
- Samson MC, Foster CS. Tuberculosis. In: Foster CS, VitaleAT (eds). Diagnosis and Treatment of Uveitis. WB Saunders Company: Philadelphia, 2002, pp 264–272.
- Gupta V, Gupta A, Rao NA. Intraocular tuberculosis: An update. Surv Ophthalmol 2007;52:561-87.
- Shimakawa M. Choroidal tuberculoma in a patient with acquired immunodeficiency syndrome. J Jpn Ophthalmol Soc 2000;104:437-41.
- DiLoreto Jr DA, Rao NA. Solitary nonreactive choroidal tuberculoma in a patient with acquired immune deficiency syndrome. Am J Ophthalmol 2001;131:138-40.
- Barondes MJ, Sponsel WE, Stevens TS, Plotnik RD: Tuberculous choroiditis diagnosed by chorioretinal endobiopsy . Am J Ophthalmol 112 460-461, 1991.
- Helm CJ, Holland GN. Ocular tuberculosis. Surv Ophthalmol 1993;38:229-56.
- Rosen PH, Spalton DJ, Graham EM. Intraocular tuberculosis. Eye 1990;4:486-92.
- Sarvananthan N, Wiselka M, Bibby K. Intraocular tuberculosis without detectable systemic infection. Arch Ophthalmol 1998;116:1386-8.
- Cimino L, Herbort CP, Aldigeri R, Salvarani C, Boiardi L. Tuberculous uveitis: A resurgent and underdiagnosed disease. Int Ophthalmol 2009 Apr;29(2):67-74. Epub 2007 May 8.
- Al-Mezaine HS, Al-Muammar A, Kangave D, Abu El-Asrar AM. Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. Int Ophthalmol 2008;28:413-23
- Biswas J, Shome D: Choroidal tubercles in disseminated tuberculosis diagnosed by the polymerase chain reaction of aqueous humor : A case report and review of the literature . Ocul Immunol Inflamm 10 293-298, 2002.
- Mehta S, Chauhan V, Hastak S: Choroidal tubercles in neurotuberculosis : Prevalence and significance . Ocul Immunol Inflamm 14 341-345, 2006.
- Gupta V, Gupta A, Sachdev N: Successful management of tubercular subretinal granulomas . Ocul Immunol Inflamm 14 35-40, 2006.
- Parikh R, Parikh S, Arun E, Thomas R: Likelihood ratios: clinical application in day-to-day practice . Ind J Ophthalmol 57 217-221, 2009.
- Gupta A, Gupta V. Tubercular posterior uveitis. Int Ophthalmol Clin 2005;45(2):71-88.
- Albini TA, Karakousis PC, Rao NA. Interferon-gamma release assays in the diagnosis of tuberculous uveitis. Am J Ophthalmol 2008;146:486-8.
- Kurup SK, Buggage RR, Clarke GL, Ursea R, Lim WK, Nussenblatt RB. Gamma interferon assay as an alternative to PPD skin testing in selected patients with granulomatous intraocular inflammatory disease. Can J Ophthalmol 2006;41(6):737-40.
- Gupta V, Arora S, Gupta A, Ram J, Bambery P, Sehgal S. Management of presumed intraocular tuberculosis: Possible role of the polymerase chain reaction. Acta Ophthalmol Scand 1998;35:237-9.