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[Ocular tuberculosis]
S Trad1, D Saadoun2, M H Errera3
1Service de médecine interne, hôpital Ambroise-Paré, AP-HP, 92104 Boulogne-Billancourt France.
Diagnosing intraocular tuberculosis (TB) is difficult, especially in low-prevalence areas. This review clarifies diagnostic tools like Interferon-gamma release assays (IGRA) and suggests tailored management guidelines based on TB prevalence.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Intraocular tuberculosis (TB) diagnosis is challenging, often relying on presumptive diagnoses in low-prevalence regions.
- Ocular Mycobacterium tuberculosis is rare, complicating definitive diagnosis and management.
Purpose of the Study:
- To outline clinical patterns indicative of ocular TB.
- To review current diagnostic guidelines, focusing on Interferon-gamma release assays (IGRA) accuracy.
- To assess diagnostic tools and therapeutic strategies based on TB prevalence.
Main Methods:
- Literature review of clinical patterns, diagnostic tools (IGRA, TST, histology, radiography), and treatment strategies.
- Analysis of diagnostic tool accuracy in relation to TB endemicity.
- Evaluation of management discrepancies between high and low TB prevalence countries.
Main Results:
- Diagnostic tool accuracy (Chest X-ray, TST, IGRA) varies significantly with TB prevalence.
- Management approaches for suspected ocular TB differ substantially between high and low prevalence settings.
Conclusions:
- Tailored diagnostic and management guidelines are essential for ocular TB, considering the patient's country's TB prevalence.
- Standardized approaches are needed to improve the diagnosis and treatment of intraocular TB globally.
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