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  • Title: Presumed tuberculosis-induced retinal vasculitis, diagnosed with positron emission tomography (18F-FDG-PET/CT), aspiration biopsy, and culture.
    Author: Doycheva D, Pfannenberg C, Hetzel J, Deuter CM, Pavesio C, Kempf VA, Schuelen E, Aschoff P, Rao N, Zierhut M.
    Journal: Ocul Immunol Inflamm; 2010 Jun; 18(3):194-9. PubMed ID: 20482398.
    Abstract:
    PURPOSE: The diagnosis of tuberculosis as an etiological factor in patients with uveitis is difficult because of lack of specific diagnostic tests. The authors report 2 cases of occlusive retinal vasculitis, in which (18)F-FDG-PET/CT was helpful for the diagnosis of tuberculosis as a presumptive cause of intraocular inflammation. METHODS: In 2 patients with severe occlusive retinal vasculitis and positive QuantiFERON TB-Gold test, (18)F-FDG-PET/CT, transbronchial needle-aspiration biopsy, and microbiological investigation were performed. RESULTS: (18)F-FDG-PET/CT showed increased fluorodeoxyglucose uptake in some mediastinal and hilar lymph nodes. After needle-aspiration biopsy of PET-positive lymph nodes, M. tuberculosis was recovered in culture in both cases. Remission of uveitis was achieved only after a combination therapy with 3 anti-tubercular agents and systemic steroids. CONCLUSION: The authors favor the use of (18)F-FDG-PET/CT in patients with sight-threatening intraocular inflammation and positive interferon-gamma release assay. Anti-tubercular therapy, together with anti-inflammatory treatment, may lead to a remission in such patients.
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