Presumed Ocular Tuberculosis: Insights from an Egyptian Cohort

To report the clinical presentations and outcome of ocular tuberculosis (OTB) in an Egyptian cohort.

The medical records of 42 consecutive patients with presumed ocular tuberculosis referred to a tertiary referral center in Alexandria, Egypt, were reviewed retrospectively.

Sixty-seven eyes of 42 patients were included in the study. The most common clinical presentation was anterior and intermediate uveitis in 25 eyes (37.3%), followed by anterior uveitis in 14 eyes (20.9%), intermediate uveitis in 11 eyes (16.4%), panuveitis in 10 eyes (14.7%), scleritis and sclerouveitis in 4 eyes (5.8%), and posterior uveitis in 3 eyes (4.5%). Nearly half of the patients, 20 patients (47.6%), were treated with combined ATT and oral corticosteroids; 8 patients (19%) received ATT alone; 6 patients (14.3%) were treated with oral corticosteroids only; and 11 patients (19.1%) were started on systemic immunosuppressants after initiation of ATT. Periocular corticosteroids were required in 14 patients (33.3%) and intravitreal Ozurdex injections in 6 patients (14.3%) to control intraocular inflammation and cystoid macular edema. The most commonly reported ocular complications of tubercular uveitis were posterior synechiae, followed by cystoid macular edema, cataract, and ocular hypertension.

Ocular tuberculosis should be considered in cases of recurrent or treatment-resistant uveitis, even in patients without systemic Tb manifestation and with normal chest imaging. In our cohort, anterior and intermediate uveitis were the most common presentations. Most cases were treated with antituberculous treatment whether alone or combined with oral corticosteroids for optimal disease control.