Intraocular tuberculosis - Clinicopathologic study of five cases

Background: Intraocular tuberculosis is a rare disease. Only approximately 18 cases of microbiologically or histopathologically proven cases of intraocular tuberculosis have been reported. Methods: Between 1984 and 1994, five cases of intraocular tuberculosis were confirmed microbiologically and histopathologically from intraocular specimens in the authors' uveitis clinic. Systemic antitubercular treatment was instituted, along with the treatment for the ocular inflammation. Results: Clinical presentation included subretinal abscess (two cases), granulomatous anterior uveitis with scleral perforation, an exudative mass in the anterior chamber, and choroidal mass with panuveitis (one case each). Aqueous aspirate in three patients and eviscerated material in the other two showed presence of acid fast bacilli. One globe that required enucleation revealed granulomatous inflammation with caseation necrosis. Two patients showed a significant response to antitubercular therapy, whereas the other three patients eventually required evisceration or enucleation. Conclusions: Intraocular tuberculosis can have protean manifestations and variable response to systemic antitubercular therapy.