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  • Title: Combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without detectable systemic infection.
    Author: Ooi YL, Tai LY, Subrayan V, Tajunisah I.
    Journal: Ocul Immunol Inflamm; 2011 Oct; 19(5):370-2. PubMed ID: 21834697.
    Abstract:
    PURPOSE: To report a rare case of combined optic neuropathy and central retinal artery occlusion in presumed ocular tuberculosis without systemic infection. CASE REPORT: A young man presented with sudden onset of decreased vision in his left eye with combined optic disc swelling and central retinal artery occlusion in a background of vasculitic changes of the same eye. There were no signs or symptoms of active systemic tuberculosis infection. Chest X-ray and computed tomography thorax findings were normal and sputum cultures for tuberculosis were negative. The Mantoux and QuantiFERON-TB Gold tests were strongly positive. No tuberculosis polymerase chain reaction testing was done. Anti-tuberculosis therapy was initiated, based on the strong clinical evidence. CONCLUSION: The ocular findings improved remarkably with the anti-tuberculosis treatment, although the left eye vision remained poor. A high index of suspicion is required to diagnose ocular tuberculosis when all other systemic investigations are negative, especially in this part of the world where tuberculosis is endemic.
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