关键词: 结核, 眼, 体征和症状, 综述文献(主题), 总结性报告(主题)

Abstract:

Objective The clinical features of ocular tuberculosis patients were summarized and analyzed in order to improve clinical diagnosis and treatment.Methods The clinical manifestations, laboratory findings, treatment and prognosis of one case with eyelid tuberculosis were reported, and the corresponding domestic and foreign literatures were reviewed and analyzed. The PubMed, Wanfang, Weipu, and CNKI databases were searched by using “ocular tuberculosis” and “eye; tuberculosis” as search terms and the date of retrieval was set from January 2000 to December 2017. The patients’ general condition, duration of disease, ocular tuberculosis involving site, clinical manifestations, basal status and complications, tuberculosis infections on other sites, major diagnostic methods, treatment, and outcomes were collected. The literatures with complete clinical data were included in this analysis, while the review literatures, duplicate publications, and literatures having incomplete data were excluded. A total of 57 articles were obtained through screening and 61 cases of ocular tuberculosis were reported in these articles.Results The 36-year-old male patient showed painless masses of the right lower eyelid and ulcerated suppurative pus as the main manifestations. No concurrent other parts of tuberculosis infection was found. The secretions were checked by acid-fast staining and real-time quantitative PCR to confirm the presence of Mycobacterium tuberculosis infection. The prognosis was good after anti-tuberculosis and local dressing treatment. Through literatures review, data on 61 patients with ocular tuberculosis were obtained. The total number of subjects was 62 cases including the case reported in this study. There were 27 males and 35 females, who aged from 3-83 years. 35 cases were complicated with tuberculosis in other sites. 9 cases were binocular tuberculosis and 53 cases were monocular tuberculosis. There were 41 cases with intraocular tuberculosis, mainly manifested as changes in vision; among them, 19 cases improved, 9 were blind, 5 had impaired vision, and 5 were cured after treatment. As for the 23 cases with orbital and ocular adnexal tuberculosis, local mass and abnormal secretions were the main manifestations; among them, 8 cases were cured, and 7 cases improved.Conclusion The clinical manifestations of ocular tuberculosis are not typical. The prognosis of orbital and ocular adnexal tuberculosis is good. The intraocular tuberculosis has a great impact on visual acuity. Clinicians should be alert to ocular tuberculosis so as to avoid missed diagnosis and misdiagnosis.

Key words: Tuberculosis, ocular, Signs and symptoms, Review literature as topic, Consensus development conferences as topic