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Tuberculous orbital apex syndromes.
E H Hughes1, H Petrushkin, N A Sibtain
1Medical Eye Unit, St Thomas' Hospital, London, UK.
The British Journal of Ophthalmology
|July 11, 2008
Summary
Tuberculosis (TB) can cause orbital apex syndromes, affecting vision. Prompt treatment with anti-TB drugs and corticosteroids rapidly restored vision in all patients.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Radiology
Background:
- Orbital apex syndrome (OAS) is a rare condition.
- Tuberculosis (TB) is an increasing global health concern.
- Diagnosing TB-induced OAS can be challenging.
Observation:
- A retrospective review identified seven patients with presumed TB-OAS.
- Patients were primarily immigrants, HIV-negative, and presented with severe vision loss.
- Constitutional symptoms were present in all patients.
Findings:
- Magnetic Resonance Imaging (MRI) revealed abnormalities in six patients.
- All patients achieved significant visual recovery (6/9 or better) within weeks.
- Treatment involved antituberculous therapy and systemic corticosteroids.
Implications:
- TB-OAS requires high clinical suspicion, especially in at-risk populations.
- Early diagnosis and combined treatment lead to favorable visual outcomes.
- This highlights the importance of considering TB in OAS differential diagnosis.
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