Differences between Mycobacterium chimaera and tuberculosis Using Ocular Multimodal Imaging: A Systematic Review.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Medical Imaging

Background:

• Ocular infections caused by Mycobacterium chimaera and Mycobacterium tuberculosis present similar, non-specific diagnostic patterns.
• Ocular manifestations can be the initial sign of systemic infection, making timely diagnosis critical for treatment efficacy and patient outcomes.
• Distinguishing chorioretinal lesions associated with M. chimaera from those of M. tuberculosis and other infections is imperative.

Purpose of the Study:

• To review and compare multimodal non-invasive imaging findings in ocular M. chimaera and M. tuberculosis infections.
• To highlight similarities and differences in imaging patterns between these two mycobacterial infections.
• To emphasize the role of multimodal imaging in the early diagnosis, treatment monitoring, and relapse detection of ocular infections.

Main Methods:

• Literature review of multimodal non-invasive imaging modalities.
• Comparison of imaging data including ultra-wide field fundus photography, fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography.
• Analysis of in vivo examination of retinal and choroidal tissues.

Main Results:

• Multimodal imaging facilitates in vivo examination of retinal and choroidal tissues.
• Imaging findings aid in differentiating active from inactive ocular disease.
• The approach guides clinical decision-making during patient follow-up.

Conclusions:

• Multimodal imaging is crucial for differentiating ocular M. chimaera from M. tuberculosis infections.
• This diagnostic approach enables early detection, treatment response monitoring, and relapse identification.
• Effective management of ocular mycobacterial infections relies on the strategic use of multimodal imaging.