Ophthalmology in China

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The dilemma and countermeasure of diagnosis and treatment in tuberculous uveitis

PENG Xiao-yan, MAO Yu   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100005, China
  • Received:2019-09-03 Online:2019-09-25 Published:2019-09-24
  • Contact: PENG Xiao-yan, Email:drpengxy@163.com

Abstract: Tuberculous uveitis is a group of inflammatory diseases with different clinical manifestations, which mainly involving the uvea and caused by the direct invasion or immune reaction of tuberculous bacilli. There are many difficulties in diagnosis and treatment of tuberculous uveitis. Since most of the patients with presumed diagnosis of tuberculous uveitis lack of active systemic tuberculosis, to establish an association between this asymptomatic systemic infection and the uveitis carries a great risk of over-diagnosis. The use of etiological or pathological examination of intraocular fluid or tissue is limited by low detection rate and risk of invasive operations. The dilemma of treatment for tuberculous uveitis lies in the lack of culture results of pathogenic bacteria and various adverse toxic effects of anti-tuberculosis drugs. Currently, the main countermeasures to get out of the predicament include understanding of tuberculosis-related examinations, improving diagnostic accuracy of systemic tuberculous, reducing the rate of missed and misdiagnosis of tuberculosis uveitis, and summing up of clinical features of tuberculous uveitis. In addition, the standardized treatment of presumed tuberculous uveitis to retrospectively confirm the diagnosis and improve treatment the prognosis. (Ophthalmol CHN, 2019, 28: 325-327)

Key words: tuberculous uveitis/diagnosis, tuberculous uveitis/treatment