Clinical Ophthalmology (Dec 2021)
Tubercular Retinal Vasculitis: Diagnostic Dilemma and Management Strategies
Abstract
Dhananjay Shukla,1 Jay Kalliath,2,* Anuradha Dhawan3,* 1Retina- Vitreous Service, Ratan Jyoti Netralaya, Gwalior, India; 2Department of Ophthalmology, NMC Specialty Hospital, Abu Dhabi, United Arab Emirates; 3Retina- Vitreous Service, Centre for Sight Group of Eye Hospitals, N. Delhi, India*These authors contributed equally to this workCorrespondence: Dhananjay ShuklaRetina-Vitreous Service, Ratan Jyoti Netralaya, Gwalior, 474002, IndiaTel +917745963548Email [email protected]: Ocular tuberculosis (OTB) is a rare, extrapulmonary manifestation of systemic TB, which has been a global etiology of uveitis for centuries, though concentrated in the developing world. OTB remains difficult to diagnose clinically despite a plethora of conventional and modern investigations. Tubercular retinal vasculitis (TRV) is a common and specific presentation of OTB but is variably defined in the literature in terms of clinical profile and the investigations essential for diagnosis and treatment. Ironically, the need and duration of antitubercular treatment is uncertain for this manifestation of ocular TB. The rationale and utility for corticosteroids is similarly equivocal for TRV. This review attempts to tease out a commonsense approach from the best available evidence and consensus in the literature to suspect, investigate and diagnose TRV with reasonable certainty, and institute appropriate treatment with due ethnic and geographic considerations.Keywords: ocular tuberculosis, tubercular uveitis, occlusive retinal periphlebitis, tuberculin skin test, chest radiography, antitubercular treatment
