Ocular tuberculosis

Tuberculosis is a very common disease in India. Ocular tuberculosis is an extrapulmonary mycobacterial infection with varied manifestations. In recent years, ocular involvement due to TB has re-emerged. The most common manifestation of ocular tuberculosis in patients with pulmonary tuberculosis is choroiditis. Retinal periphlebitis is rarely caused by direct invasion of the retina by tubercle bacilli. Retinal tuberculosis is usually, but not always, secondary to an underlying choroiditis. The lack of any uniform diagnostic criteria for intraocular tuberculosis, in either immunocompetent or immunocompromised individuals, has contributed to the confusion regarding diagnosis and management. . It is imperative for physicians to consider this diagnosis in their differential, as ocular tuberculosis can present in a fashion similar to that of more common conditions causing ocular inflammation. Techniques such as ultra-wide field fundus photography, fluorescein and indocyanine green angiography, optical coherence tomography and most recently, optical coherence tomography angiography, provide valuable information regarding the disease progression and severity. This review article focuses on the clinical characteristics and diagnostic modalities useful in the diagnosis of intraocular TB. Specifically, IFN-gamma Release Assays (IGRAs) and polymerase chain reactions are discussed. The use of corticosteroids along with anti-tuberculous medications and potential side-effects are discussed.