Título / Title

RARE PRESENTATION OF PRESUMED OCULAR TUBERCULOSIS IN AN IMMUNOCOMPETENT PATIENT

Introdução / Purpose

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis(MTB) that priarily affects the lungs and may affect other organs, including the eye. This article aims to describe a clinical case of ocular TB without signs of active lung disease.

Material e Método / Methods

A 54-year-old man with sudden and painless loss of the vision of the right eye for the past 19 days, without any other complaints. Pulmonary tuberculosis treated 45 years ago and retreated 5 years after the first treatment. His initial visual acuity with correction e was couting fingers at 5 meters for the right eye and for the left eye was 1,0.The fundus examination revelead optical disc blurring, periparillary subretinal hemorrhage and a macular star. Purified protein derivative (PPD) skintesting was not reactant. Laboratory investigation was negative. The chest radiograph did not show significant changes.The diagnosis of ocular TB was presumed. The patient was put on oral steroid & on full antituberculosis treatment(ATT) with Isoniazid 600mg/day, Rifampicin 300mg/day, Pyrazinamid1600mg/Day and Ethambutol1100mg/day. Patient had significant progress with the treatment. On review after one month, the patient showed significant improvement of the visual acuityto 0,6 in the right eye and ofthe disturbances of the fundus examination.

Resultados / Results

Ocular TB can either occur as a primary active infection or a secondary infection from a distant site, usually through hematogenous spread. Drug regimens for ocular tuberculosis are similar to those for pulmonary or extrapulmonary tuberculosis, and a complete four-drug regimen should be given because of the concern of developing drug resistance with a one or two-drugs

Discussão e Conclusões / Conclusion

This case shows the fact that tuberculosis can present variable clinical manifestations and has complicated efforts to name the clinical indicators that suggest a diagnosis of intraocular tuberculosis. Early diagnosis and timely intervention is necessary to prevent complications

Palavras Chave

ocular tuberculosis, PPD, uveitis,

Area

CLINICAL RETINA