Clinical spectrum of tuberculous optic neuropathy

Ellen J. Davis, Sivakumar R. Rathinam, Annabelle A. Okada, Sharon L. Tow, Harry Petrushkin, Elizabeth M. Graham, Soon Phaik Chee, Yan Guex-Crosier, Eva Jakob, Ilknur Tugal-Tutkun, Emmett T. Cunningham, Jacqueline A. Leavitt, Ahmad M. Mansour, Kevin L. Winthrop, William L. Hills, Justine R. Smith

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

Purpose: Tuberculous optic neuropathy may follow infection with Mycobacterium tuberculosis or administration of the bacille Calmette-Guerin. However, this condition is not well described in the ophthalmic literature. Methods: Ophthalmologists, identified through professional electronic networks or previous publications, collected standardized clinical data relating to 62 eyes of 49 patients who they had managed with tuberculous optic neuropathy. Results: Tuberculous optic neuropathy was most commonly manifested as papillitis (51.6 %), neuroretinitis (14.5 %), and optic nerve tubercle (11.3 %). Uveitis was an additional ocular morbidity in 88.7 % of eyes. In 36.7 % of patients, extraocular tuberculosis was present. The majority of patients (69.4 %) had resided in and/or traveled to an endemic area. Although initial visual acuity was 20/50 or worse in 62.9 % of 62 eyes, 76.7 % of 60 eyes followed for a median of 12 months achieved visual acuities of 20/40 or better. Visual field defects were reported for 46.8 % of eyes, but these defects recovered in 63.2 % of 19 eyes with follow-up. Conclusion: Visual recovery from tuberculous optic neuropathy is common, if the diagnosis is recognized and appropriate treatment is instituted. A tuberculous etiology should be considered when evaluating optic neuropathy in persons from endemic areas.

Original languageEnglish (US)
Pages (from-to)183-189
Number of pages7
JournalJournal of Ophthalmic Inflammation and Infection
Volume2
Issue number4
DOIs
StatePublished - Dec 2012

Keywords

  • Optic neuropathy
  • Presentation
  • Tuberculosis
  • Visual outcome

ASJC Scopus subject areas

  • Ophthalmology
  • Infectious Diseases

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    Davis, E. J., Rathinam, S. R., Okada, A. A., Tow, S. L., Petrushkin, H., Graham, E. M., Chee, S. P., Guex-Crosier, Y., Jakob, E., Tugal-Tutkun, I., Cunningham, E. T., Leavitt, J. A., Mansour, A. M., Winthrop, K. L., Hills, W. L., & Smith, J. R. (2012). Clinical spectrum of tuberculous optic neuropathy. Journal of Ophthalmic Inflammation and Infection, 2(4), 183-189. https://doi.org/10.1007/s12348-012-0079-5