[Pediatric ocular tuberculosis: Epidemiological and clinical profile and particular issues regarding treatment]

Tuberculosis remains the third leading cause of infectious disease mortality worldwide. Ocular tuberculosis, though rare, is on the rise, particularly in relation to the HIV/AIDS epidemic. In children, this condition presents a diagnostic challenge due to its clinical polymorphism and the frequent absence of lesions that are accessible for histologic examination.

To study the epidemiological, clinical, and therapeutic profiles of ocular tuberculosis in children through a case series.

This retrospective study includes 78 cases of ocular tuberculosis in HIV-negative children.

A history of tuberculosis exposure was found in 13 cases; extraocular tuberculosis was observed in 34 cases; a palpebral nodule in 6 cases; follicular conjunctivitis in 16 cases; interstitial keratitis in 12 cases; uveitis in 40 cases, including 3 associated with tuberculous meningitis; retinal vascular occlusion in 16 cases; and multifocal choroiditis in 11 cases. Diagnosis was based on tissue biopsy, cerebrospinal fluid culture, and a combination of clinical and ancillary findings.

Ocular tuberculosis in children remains a rare entity, often indicative of latent or active tuberculosis infection. Its diagnosis is based on a combination of clinical and laboratory data, with the QuantiFERON-TB Gold® test proving to be useful. Treatment with antitubercular drugs in combination with corticosteroids generally leads to an improvement in visual prognosis.

Ocular tuberculosis presents a diagnostic challenge in children. Early and appropriate management can significantly improve the visual prognosis.