First Author: O.Zborovska UKRAINE
Co Author(s): O. Dorokhova
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To determine applicability of enhanced depth imaging optical coherence tomography (EDI-OCT) in the diagnostics of tuberculous chorioretinitis.
The Filatov Institute of Eye Diseases and Tissue Therapy, NAMS Ukraine, Odessa, Ukraine.
The study included eight patients with presumed tuberculous chorioretinitis. Carrying Mantoux test was impossible in 7 patients due to risk of central vision loss. All patients were examined by EDI-OCT in addition to standard ophthalmological examinations.
We revealed choroidal thickening in inflammatory foci by EDI-OCT in 7 patients. We also determined RPE-choroid complex elevation. Secondary retinal alterations were also present over the area of choroidal thickening. These patients were assigned to ex juvantibus anti TB drugs. On ex juvantibus therapy positive dynamics had been reached, and patients were assigned to anti-TB therapy for 6 – 9 months. Upon further observation and treatment all these patients had chorioretinal scar formation. Complete remission with anti-TB therapy termination was achieved in 6 months in 2 patients. In 5 patients complete remission was achieved in 9 months. Choroidal thickening and RPE-choroid complex elevation was not observed by EDI-OCT After full chorioretinal scar formation in all patients. In 1 case with presumed tuberculous chorioretinitis choroidal changes were insignificant by EDI-OCT. But iso-hyperreflective intrararetinal mass was determined. As known, isolated neuroretinal involvment extremely indistinctive for tuberculous chorioretinitis. Search for a possible aetiology of chorioretinitis was continued, resulting in diagnosis ocular bartonellosis ('cat scratch disease'). On the specific therapy regression of inflammation and resorption of focus was achieved in the short term.
EDI-OCT can be effectively applied in the diagnostics of tuberculous chorioretinitis, or even act as a key method of examination in cases of carrying the Mantoux test impossibility.