Oküler Tüberküloz I: Epidemiyoloji, Patogenez ve Klinik Özellikler

The World Health Organization has declared tuberculosis (TB) to be a global emergency, as it remains the most common\udsingle cause of morbidity and mortality worldwide. TB is caused by the acid-fast bacillus Mycobacterium tuberculosis\udand primarily affects the lungs [pulmonary TB (PTB)]. It can also affect any other part of the body [extrapulmonary\udTB (EPTB)]. It is estimated that 1.4% of patients with PTB will eventually develop ocular disease; however, in the majority\udof cases of ocular TB, PTB may not be documented. Ocular TB infection is usually a result of hematogenous spread\udduring PTB or EPTB. Symptomatic disease most commonly develops after reactivation of dormant foci in the ocular tissue\udrather than being the manifestation of the initial infection. Immune-mediated ocular TB can occur due to hypersensitivity\udto M. tuberculosis antigens from a distant focus (such as lungs), despite the absence of the bacterium in the eye.\udThe most common clinical presentation of intraocular inflammation (uveitis) due to TB appears to be posterior uveitis,\udfollowed by anterior uveitis, panuveitis and intermediate uveitis. The absence of uniform diagnostic criteria for intraocular\udTB has led to confusion regarding its diagnosis and management. Recent studies on the clinical importance of purified\udprotein derivative (PPD) skin test, interferon-gamma release assays, chest computed tomography and polymerase\udchain reaction have provided a new approach to diagnosing ocular TB. This review series focuses on the clinical features,\uddiagnostic techniques, diagnostic criteria, and treatment modalities in the light of recent literature. (Turk J Ophthalmol\ud2011; 41: 171-81