Two Cases of Retinal Vasculitis in Ocular Tuberculosis Involving Different Parts of the Vascular System

Vol. 1 No. 1 : 2006 (91-93)

Kok Howe Sen Kok Howe Sen
Tara Mary George Tara Mary George
Mae-Lynn Catherine Bastion Mae-Lynn Catherine Bastion
Muhaya Hj Mohamad Muhaya Hj Mohamad

Abstract
Two case reports of retinal vasculitis in presumptive ocular tuberculosis are presented. Case 1 is a 26-year-old Malay woman who had phlebitis with choroidal lesions and case 2 is a 27 year old Malay woman who had occlusive arteritis. Both subjects had positive Mantoux tests with negative systemic screen. Both responded clinically to anti-tuberculous therapy within days of commencing therapy. There was however concurrent increase in vitritis which decreased following anti-inflammatory doses of oral corticosteroids. These two cases represent a rare mode of presentation of ocular tuberculosis for which a high index of suspicion is needed. Multidrug anti-tuberculous therapy should be combined with oral corticosteroids for effective treatment.
Keywords : Mantoux, ocular tuberculosis, retinal vasculitis,
Abstrak
Dua laporan kes vaskulitis retina pada tuberkulosis okular presumptif dibentangkan. Kes 1 ialah seorang wanita Melayu berumur 26 tahun yang mengadu flebitis dengan lesi koroid. Kes 2 ialah seorang wanita Melayu berumur 27 tahun yang mengadu sakit arteritis oklusif. Kedua-dua pesakit menunjukkan ujian Mantoux positif dengan saringan sistemik negatif. Kedua-duanya menunjukkan respons baik terhadap terapi anti-tuberkulosis beberapa hari selepas terapi dimulakan. Tetapi serentak dengan kejadian ini, peningkatan vitritis berlaku. Vitritis menunjukkan penurunan selepas sahaja kortikosteroid oral diberi. Cara presentasi tuberkulosis okular kedua-dua kes ini jarang ditemui dan indeks kecurigaan yang tinggi diperlukan. Terapi anti-tuberkulosis pelbagai ubat perlu digabungkan dengan kortikosteroid oral untuk rawatan efektif.
Kata Kunci : Mantoux, tuberkulosis okular, vaskulitis retina,

Correspondance Address
Dr Mae-Lynn Catherine Bastion, Department of Ophthalmology,Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000 Kuala Lumpur, Malaysia. Email: maelynnbdr@hotmail.com