Summary
Intraocular TB has diverse manifestations. The various clinical signs of uveitis, broad-based posterior synechiae, SLC and retinal vasculitis may be strong predictors of tubercular etiology. The presence of concomitant extraocular TB is rare. Diagnosis is often presumed in the presence of positive TST or IGRAs (QFT and ELISpotPLUS or T-SPOT.TB) or radiological findings (CXR or CT scan or PET-CT). Although seldom available, the presence of AFB on direct smear or culture of MTB from the intraocular samples constitutes the gold standard for diagnosing intraocular TB. PCR provides a rapid method for diagnosing intraocular TB from ocular fluids. ATT is highly effective, and should be monitored for adverse effects such as paradoxical worsening of uveitis and hepatotoxicity.
Expert Rev Ophthalmol. 2012;7(4):341-349. © 2012 Expert Reviews Ltd.