Bilateral Optic Perineuritis in Tuberculosis-Immune Reconstitution Inflammatory Syndrome

被引:1
作者
Fatimah-Halwani, Ismail [1 ]
Wahab, Zulaikha [1 ]
Masnon, Nurul Ain [1 ]
Hitam, Wan-Hazabbah Wan [1 ]
Shatriah, Ismail [1 ]
Haron, Juhara [2 ]
机构
[1] Univ Sains Malaysia, Sch Med Sci, Dept Ophthalmol & Visual Sci, Hlth Campus, Kubang Kerian, Malaysia
[2] Univ Sains Malaysia, Sch Med Sci, Dept Radiol, Hlth Campus, Kubang Kerian, Malaysia
关键词
immune reconstitution inflammatory syndrome; idiopathic orbital inflammatory disease; corticosteroids; tuberculosis; optic perineuritis; SECONDARY;
D O I
10.7759/cureus.27600
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Optic perineuritis (OPN) in pulmonary tuberculosis (PTB) patients while on anti-tuberculous treatment is rare. It may occur due to tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS). Visual prognosis is poor if not treated early. We report a rare case of bilateral OPN in an elderly patient on treatment for PTB. A 79-year-old Malay man presented with a painless bilateral blurring of vision for three weeks. He was diagnosed to have PTB and has been on anti-tuberculous treatment for five months. Visual acuity in both eyes was only counting fingers. Optic nerve function tests were significantly reduced bilaterally. Fundoscopy showed bilateral segmental temporal optic disc pallor. Both visual field assessments were constricted. Other infective screenings and tumor markers were negative. Neuro-imaging revealed bilateral OPN involving the intraorbital segment. High-dose intravenous corticosteroid therapy was commenced, followed by slow tapering of oral prednisolone. Anti-tuberculous treatment was continued for a total course of nine months. The left visual acuity improved to 3/60. However, the right eye vision remained poor. His general condition was good.
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页数:4
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