GRANÜLOMATOZ GÖZ PATOLOJİSİ SAPTANARAK GÖZ TÜBERKÜLOZU KABUL EDİLEN HASTALARDA ANTİTÜBERKÜLOZ TEDAVİ: TÜRKİYE TEK MERKEZ DENEYİMİ

Öz

Amaç: Göz tüberkülozu hem terminoloji, hem tanı kriterleri hem de tedavi seçenekleri açısından halen tartışmalı bir konu olarak kabul edilmektedir. Yeni yaklaşımlar olmasına rağmen ortak bir tanı/tedavi algoritması bulunmamaktadır. Bu çalışmada “Göz tüberkülozu hastalarının” tedavi sonuçları değerlendirilmiştir. Gereç ve Yöntem: Latent tüberküloz enfeksiyonu olan, başka tanısı olmayan, steroid tedavisine yanıt vermeyen ve göz tüberkülozu düşünülen olgulara antitüberküloz tedavisi verildi. Bulgular: Göz tüberkülozu düşünülen ve en az üç ay süreyle antitüberküloz tedavisi gören ve düzenli takipleri yapılan 64 olgu (32 kadın, 32 erkek, ortalama 42,1±12,09 yıl) değerlendirildi. Ortalama antitüberküloz tedavi süresi 8,18±2,17 ay (3-15 ay) idi. Tedaviden sonra 64 hastanın toplam 47’si (%73,4) görmesinde iyileşme bildirdi. Bu hastaların sadece 36’sında (31 bilateral, 5 tek taraflı, toplam 67 göz) tedavi öncesi ve sonrası objektif görme değerlendirmesi yapılabildi. Bu hastalarda hastalık tutulumu 61 gözde (%91) üveit (ön, orta, arka, panüveit), 6 gözde (%9) retinal vaskülitti. Altmış yedi gözde yapılan görme analizine göre, 42 (%62,7)’sinin görme keskinliklerinde değişken düzeylerde iyileşme tespit edildi. Ortalama sağ göz görme keskinliği tedavi öncesi 0,56±0,049, tedavi sonrası 0,71±0,047 idi (p<0,001). Ortalama sol göz görme keskinliği tedavi öncesi 0,60±0,51, tedavi sonrası 0,73±0,043 idi (p<0,004). Sonuç: Latent tüberküloz enfeksiyonu varlığında göz tüberkülozu düşünülen olgularda antitüberküloz tedavisi ile başarılı sonuçlar alınabilir

Anahtar Kelimeler

• Ekstrapulmoner tüberküloz
• granülomatöz göz patolojileri
• göz tüberkülozu

ANTI-TUBERCULOSIS TREATMENT IN PRESUMED OCULAR TUBERCULOSIS PATIENTS WITH GRANULOMATOSIS OCULAR PATHOLOGIES: SINGLE CENTER EXPERIENCE FROM TURKIYE

Öz

Objective: Ocular tuberculosis is still considered to be a controversial issue in terms of both terminology and diagnostic criteria and treatment options. There is no common diagnostic/treatment algorithm even though new approaches exist.In this study, the results of the treatment of “presumed ocular tuberculosis patients” are evaluated. Materials and Methods: Anti-tuberculosis treatment was given to cases who had latent tuberculosis infection, had no other diagnosis and who did not respond to steroid treatment. These cases were considered to have presumed ocular tuberculosis. Results: Sixty four cases who were considered to have “presumed ocular tuberculosis” received anti-tuberculosis treatment for a minimum of three months and were followed up regularly. The 64 cases were made up of 32 women and 32 men, with a mean age of 42.1±12.09 years. Mean antituberculosis treatment duration was 8.18±2.17 months (3-15 month). After the treatment, 47 (73.4%) of 64 patients reported improvement in vision. Only 36 of these 64 cases (31 bilateral, 5 unilateral, 67 eyes in total) were evaluated with objective vision test before and after the treatment. Disease involvement was uveitis (anterior, intermediate, posterior, panuveitis) in 61 eyes (91%), and retinal vasculitis in 6 eyes (9%). According to the vision analysis among 67 eyes, 42 (62.7%), visual acuities were detected to be improved at variable levels. Mean right eye visual acuity was 0.56±0.049 before treatment, and 0.71±0.047 after treatment (p<0.001). Mean left eye visual acuity was 0.60±0.51 before treatment, and 0.73±0.043 after treatment (p<0.004). Conclusion: In the presence of latent tuberculosis infection, successful results can be obtained with antituberculosis treatment for cases diagnosed as presumed ocular tuberculosis.

Anahtar Kelimeler

• Extra-pulmonary tuberculosis
• granulomatosis ocular pathologies
• ocular tuberculosis

Kaynakça

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