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Pathogenesis and Pathology of Ocular Tuberculosis

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Ocular Tuberculosis

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

Abstract

Ocular tuberculosis is a chronic infection which results from bacterial dissemination from the lungs to ocular tissues followed by reactivation. It is challenging to diagnose in the absence of pulmonary tuberculosis due to absence/paucity of acid-fast bacilli (AFB). Usually with good immune response, the bacteria are killed by delayed hypersensitivity in which activated macrophages produce INF-γ and TNF-α. In case of poor immune response, the mycobacteria escape and get disseminated to the eye and other organs.

There are no well-defined criteria for the diagnosis of intraocular tuberculosis. Most of the indirect assays/tests performed on the clinical suspicion of tuberculosis lack specificity to distinguish between latent and active tuberculosis infection.

Histopathology shows granulomatous or nongranulomatous inflammation with necrosis. However, this needs to be supported by laboratory evidence in the form of AFB by microscopy/culture or mycobacterial DNA by PCR.

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References

  1. Tabbara KF. Tuberculosis. Curr Opin Ophthalmol. 2007;8(6):493–501.

    Article  Google Scholar 

  2. Ottenhoff TH. The knowns and unknowns of the immunopathogenesis of tuberculosis. Int J Tuberc Lung Dis. 2012;16(11):1424–32.

    Article  CAS  PubMed  Google Scholar 

  3. Sharma A, Thapa B, Lavaju P. Ocular tuberculosis: an update. Nepal J Ophthalmol. 2011;3:52–67.

    CAS  PubMed  Google Scholar 

  4. Glassroth J, Robins AG, Snider DE. Tuberculosis in the 1980s. N Engl J Med. 1980;302:1441–50.

    Article  CAS  PubMed  Google Scholar 

  5. Gupta V, Gupta A, Rao NA. Intraocular tuberculosis: an update. Surv Ophthalmol. 2007;52(6):561–87.

    Article  PubMed  Google Scholar 

  6. Demirci H, Shields CL, Shields JA, Eagle Jr RC. Ocular tuberculosis masquerading as ocular tumors. Surv Ophthalmol. 2004;49:78–89.

    Article  PubMed  Google Scholar 

  7. Sheu SJ, Shyu JS, Chen LM, Chen YY, Chirn SC, Wang JS. Ocular manifestations of tuberculosis. Ophthalmology. 2001;108:1580–5.

    Article  CAS  PubMed  Google Scholar 

  8. Liaquat J. Isolated eyelid tuberculosis. Uni Med Health Science. 2007;6(1):37–9.

    Google Scholar 

  9. Biswas J, Kumar SK, Rupauliha P, et al. Detection of mycobacterium tuberculosis by nested polymerase chain reaction in a case of subconjunctival tuberculosis. Cornea. 2002;21:123–5.

    Article  PubMed  Google Scholar 

  10. Tabbara KF. Ocular tuberculosis: anterior segment. Int Ophthalmol Clin. 2005;45:57–69.

    Article  PubMed  Google Scholar 

  11. Zaborowski AG, Gundry BN, Masenya ME, Visser L. Primary tuberculous keratoconjunctivitis. Eye. 2006;20:978–9.

    Article  CAS  PubMed  Google Scholar 

  12. Bansal RK, Malhotra C, Bhatia R, et al. Tubercular dacryoadenitis: a case report and review of literature. Indian J Pathol Microbiol. 2006;49:385–7.

    PubMed  Google Scholar 

  13. Raina UK, Jain S, Monga A, et al. Tubercular preseptal cellulites in children: a presenting feature of underlying systemic tuberculosis. Ophthalmology. 2004;111:291–6.

    Article  PubMed  Google Scholar 

  14. Smith DE, Blasi A. Acquired abducens nerve palsy secondary to tuberculosis. Optometry. 2009;80(10):567–71.

    Article  PubMed  Google Scholar 

  15. Pecorella I, Vingolo E, Ciardi A, Grenga P. Scleral ossification in phthisical eyes. Orbit. 2006;25:35–8.

    Article  PubMed  Google Scholar 

  16. Gupta N, Chawla B, Venkatesh P, Tandon R. Necrotizing scleritis and peripheral ulcerative keratitis in a case of Sweet’s syndrome found culture-positive for mycobacterium tuberculosis. Ann Trop Med Parasitol. 2008;102:557–60.

    Article  CAS  PubMed  Google Scholar 

  17. Saricaoğlu MS, Sengun A, Guven D, Karakurt A. Ocular tuberculosis with angle granuloma. Eye. 2004;18:219–20; discussion 220–1.

    Google Scholar 

  18. Sen S, Kashyap S, Singh UB, Nagasuresh V, Chand M, Garg SP. Intraocular tuberculosis mimicking retinoblastoma. Diagn Cytopathol. 2003;28(2):107–9.

    Article  PubMed  Google Scholar 

  19. Ohta K, Yamamoto Y, Arai J, et al. Solitary tuberculoma in an patient with chest wall tuberculosis. Br J Ophthalmol. 2003;87:795.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Mehta S, Chauhan V, Hastak S, et al. Choroidal tubercles in neurotuberculosis: prevalence and significance. Ocul Immunol Inflamm. 2006;14:341–5.

    Article  PubMed  Google Scholar 

  21. Levecq LJ, De Potter P. Solitary choroidal tuberculoma in an immunocompetent patient. Arch Ophthalmol. 2005;123(6):864–6.

    Article  PubMed  Google Scholar 

  22. Basu S, Wakefield D, Biswas J, Rao NA. Pathogenesis and pathology of intraocular tuberculosis. Ocul Immunol Inflamm. 2015;23(4):353–7.

    Article  Google Scholar 

  23. Mortaz E, Varahram M, Farnia P, Bahadori M, Masjedi MR. New aspects in immunopathology of mycobacterium tuberculosis. ISRN Immunol. 2012;11. doi:10.5402/2012/963879.

  24. Krishnan N, Robertson BD, Thwaites G. The mechanisms and consequences of the extra-pulmonary dissemination of mycobacterium tuberculosis. Tuberculosis (Edinb). 2010;90:361–6.

    Article  CAS  Google Scholar 

  25. Rao NA, Albini TA, Kumaradas M, Pinn ML, Fraig MM, Karakousis PC. Experimental ocular tuberculosis in guinea pigs. Arch Ophthalmol. 2009;127(9):1162–6.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rao NA, Saraswathy S, Smith RE. Tuberculous Uveitis: distribution of mycobacterium tuberculosis in the retinal pigment epithelium. Arch Ophthalmol. 2006;124(12):1777–9.

    Article  PubMed  Google Scholar 

  27. Thayil SM, Albini TA, Nazari H, Andrew A, et al. Local ischemia and increased expression of vascular endothelial growth factor following ocular dissemination of mycobacterium tuberculosis. PLoS One. 2011;6:e.28383.

    Article  Google Scholar 

  28. Garip A, Diedrichs-Möhring M, Thurau SR, Deeg CA, Wildner G. Uveitis in a patient treated with Bacille-Calmette-Guérin: possible antigenic mimicry of mycobacterial and retinal antigens. Ophthalmol. 2009;116(12):2457–62.

    Google Scholar 

  29. Clemens DL, Horwitz MA. Characterization of the mycobacterium tuberculosis phagosome and evidence that phagosomal maturation is inhibited. J Exp Med. 1995;181:257–70.

    Article  CAS  PubMed  Google Scholar 

  30. Fairbairn IP. Macrophage apoptosis in host immunity to mycobacterial infections. Biochem Soc Trans. 2004;32(3):496–8.

    Article  CAS  PubMed  Google Scholar 

  31. de Chastellier C. The many niches and strategies used by pathogenic mycobacteria for survival within host macrophages. Immunobiology. 2009;214:526–42.

    Article  PubMed  Google Scholar 

  32. Kaufmann SHE. The macrophage in tuberculosis: sinner of saint? The T cell decides. Pathobiology. 1991;59:153–5.

    Article  CAS  PubMed  Google Scholar 

  33. Philips JA, Ernst JD. Tuberculosis pathogenesis and immunity. Annu Rev Pathol. 2012;7:353–84.

    Article  CAS  PubMed  Google Scholar 

  34. Dieli F, Troye-Blomberg M, Ivanyi J, et al. Vgamma9/Vdelta2 T lymphocytes reduce the viability of intracellular mycobacterium tuberculosis. Eur J Immunol. 2000;30:1512–9.

    Article  CAS  PubMed  Google Scholar 

  35. Thomson MJ, Albert DM. Ocular tuberculosis. Arch Ophthalmol. 2005;123:844–9.

    Article  Google Scholar 

  36. Wroblewski KJ, Hidayat AA, Neafie RC, Rao NA, Zapor M. Ocular tuberculosis: a clinicopathologic and molecular study. Ophthalmology. 2011;118(4):772–7.

    Article  PubMed  Google Scholar 

  37. Yeh S, Sen HN, Colyer M, Zapor M, Wroblewski K. Update on ocular tuberculosis. Curr Opin Ophthalmol. 2012;2:551–6.

    Article  Google Scholar 

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Compliance with Ethical Requirements

Seema Sen declares no conflict of interest. No human or animal studies were carried out by the author for this chapter.

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Authors and Affiliations

  1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Department of Ocular Pathology, New Delhi, India

    Seema Sen MD, Pathology

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  1. Seema Sen MD, Pathology
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Correspondence to Seema Sen MD, Pathology .

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Editors and Affiliations

  1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

    Atul Kumar

  2. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

    Rohan Chawla

  3. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

    Namrata Sharma

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Sen, S. (2017). Pathogenesis and Pathology of Ocular Tuberculosis. In: Kumar, A., Chawla, R., Sharma, N. (eds) Ocular Tuberculosis. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-57520-9_2

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  • DOI: https://doi.org/10.1007/978-3-319-57520-9_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-57519-3

  • Online ISBN: 978-3-319-57520-9

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