Anterior segment optical coherence tomography findings of presumed intraocular tuberculosis

Abstract

Purpose: To report a case of anterior segment findings of presumed ocular tuberculosis using anterior-segment optical coherence tomography (AS-OCT; Visante, Carl Zeiss Meditec, Inc., Dublin, CA, USA).

Methods: A 78-year-old woman with persistent right ocular injection and pain of 2 weeks’ duration was referred to our clinic. Unilateral stromal keratitis affecting the corneal periphery and angle granuloma with synechiae, scleritis, and anterior uveitis were noticed. Because of the patient’s intensely positive tuberculin skin test, she was diagnosed with presumed intraocular tuberculosis. The anatomic structures of the anterior segment were monitored by AS-OCT before and after the treatment.

Results: AS-OCT imaging showed a poorly demarcated amorphous lesion in the iridocorneal angle, corneal edema, narrowing and synechiae of the iridocorneal angle, and anterior chamber exudates and cells. Improvement of the corneal edema and a decrease of corneal thickness and exudates were observed after implementation of a daily regimen of antituberculous treatment. AS-OCT was useful for investigating the extent of the anterior synechiae and angle lesions.

Conclusions: AS-OCT allows noninvasive and noncontact analysis of the treatment response and is also useful to evaluate disease activity.

KEYWORDS::

• Mycobacterium tuberculosis
• uveitis
• anterior segment
• optical coherence tomography