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Antinuclear and antiretinal antibodies in uveitis associated with active and latent tuberculosis
Author(s) -
La Distia Nora Rina,
ten Berge Josianne CEM,
Rothova Aniki,
Schreurs Marco WJ
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13707
Subject(s) - medicine , uveitis , anti nuclear antibody , autoantibody , tuberculosis , immunology , mycobacterium tuberculosis , latent tuberculosis , quantiferon , antibody , pathology
The patients included who were not referred to ophthalmic evaluation were followed up by a questionnaire to detect possible misdiagnosis. This study was made according to the guidelines of the Helsinki Declaration, and relevant approvals have been achieved. To our knowledge, this is the first study to report objective ocular signs found in an ER without access to specialized ophthalmologic instrumentation. Twenty-four patients were included; 83% were men, 29% of the injuries were work related, and mean age was 36 years. Traumas with a history of hammering stone or metal comprised 37.5%, blunt traumas 25%, traumas with sharp objects 25% and 16% were projectile traumas. Eighteen patients (75%) were admitted to an acute ophthalmological evaluation. Six patients (25%) were not referred, all having a history of hammering metal or stone. Objective signs among the group of patients referred to further examination (n = 18) were as follows: decreased VA (n = 14); irregular pupil (n = 4); no pupillary reaction to light (n = 4); hyphaema (n = 3); open injury visual to the naked eye (n = 2); and subconjunctival haemorrhage (n = 2) (Fig. 1). Patients not referred presented the following: subconjunctival haemorrhage (n = 1), injection of eye (n = 4) and fluorescein stain (n = 1) (Fig. 1). During a 5-year period, there was not detected any misdiagnosis of patients with mechanical ocular trauma in a Danish ER without ophthalmic assistance. Our study shows that patients with a history of hammering stone or metal are only referred to an ophthalmological examination if there are obvious signs of eye injury. Hammering, as in previous studies, has been found to be the most common mechanism in ocular traumas with an IOFB (Imrie et al. 2008; Nicoara et al. 2015). Therefore, we recommend that all patients with a history of hammering stone or metal undergo an ophthalmologic examination to decrease the risk ofmisdiagnosis. References