Which clinical history findings are characteristic of ocular tuberculosis in HIV infection?

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Ocular tuberculosis is usually accompanied by constitutional symptoms, such as malaise, night sweats, and other pulmonary complaints, including shortness of breath and dyspnea.

Ocular tuberculosis can take a variety of forms. The most common ocular manifestation is anterior uveitis and disseminated choroiditis. The anterior segment inflammation may be granulomatous or nongranulomatous, with varied severity. Usually, granulomatous keratitic precipitates and posterior synechiae are present.

It is possible to have anterior uveitis without clinically active tuberculosis. Untreated chronic uveitis from tuberculosis can gradually result in panophthalmitis. Choroidal tubercle invasion in miliary tuberculosis may cause unifocal or multifocal yellowish, grayish, or whitish choroiditis, mostly in the posterior pole.

These lesions tend to show delayed hyperfluorescence that increase in size on fluorescein angiography. With time, these lesions heal with residual scars that may or may not have pigmentation. Sequela of subretinal neovascularization arising from the area of scars may be present.


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