RESUMEN
The diagnosis of OTB (Ocular tuberculosis) is usually difficult to make. Definitive diagnosis requires the identification of M. tuberculosis organisms in ocular tissues or fluids, but samples are often difficult to obtain, and biopsy may be hard to justify. We describe a 50-years-old Maghreb male, who presented a multifocal choroiditis associated with a choroidal tuberculoma on the left eye. Based on positive QuantiFERON-TB-Gold test and suggestive clinical and radiographic findings, a diagnosis of presumed ocular tuberculosis was made. Serial swept-source optical coherence tomography (SS-OCT) and widefield fundus retinographies during subsequent follow-up visits demonstrated the characterization of the atypical tuberculosis presentation and allowed the assessment of response to antitubercular therapy and oral steroids.
Asunto(s)
Coroiditis , Tuberculoma , Tuberculosis Ocular , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis Ocular/diagnóstico , Tuberculosis Ocular/tratamiento farmacológico , Tuberculosis Ocular/complicaciones , Coroiditis Multifocal/complicaciones , Coroiditis Multifocal/tratamiento farmacológico , Coroiditis Multifocal/patología , Coroides/patología , Técnicas de Diagnóstico Oftalmológico , Antituberculosos/uso terapéutico , Tuberculoma/diagnóstico , Tuberculoma/tratamiento farmacológico , Tuberculoma/complicaciones , Coroiditis/diagnóstico , Coroiditis/tratamiento farmacológico , Coroiditis/complicaciones , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodosRESUMEN
PURPOSE: To describe the clinical and epidemiological characteristics of patients with Vogt-Koyanagi-Harada (VKH) disease in Spain. METHODS: This was a retrospective multicenter analysis of data from VKH patients followed for at least 6 months. The data collected were related to demographics, clinical manifestations, treatments, and complications. RESULTS: Participants were 112 patients (224 eyes), from 13 tertiary referral centers, of mean age 37.5 ± 14.7 years; 83.9% were women. Ethnicities were 61.6% Caucasian and 30.4% Hispanic. The disease was classified as complete in 16.1%, incomplete in 55.4%, and probable in 28.6%. When seen for the first time, the clinical course was acute in 69.6%, recurrent chronic in 15.2%, and chronic in 14.3%. The most frequent treatment was corticosteroids (acute stage 42.2%, maintenance stage 55.6%). The most common complications were cataract (41.1%) and ocular hypertension (16.1%). In most eyes, visual acuity was improved (96.7%) or remained stable at the end of follow up. CONCLUSION: VKH in Spain mostly affects women and presents as incomplete acute stage disease. Visual prognosis is good. Cataract and glaucoma are the two most frequent complications.