Importance: Tuberculosis is an endemic infectious disease in developing countries. Patients receiving treatment for systemic tuberculosis may develop paradoxical growth of tuberculomas in the brain, which can lead to vision loss.
Observations: We describe 3 patients who had paradoxical development of tuberculomas in the anterior optic pathway during treatment for tuberculosis and presented with acute vision loss. These optochiasmatic tuberculomas were not present at the initial presentation of tuberculosis and appeared on brain magnetic resonance imaging at the time of presentation with vision loss. Vision improved on instituting systemic corticosteroids in addition to antituberculous treatment.
Conclusions And Relevance: As there was visual recovery after patients began receiving systemic corticosteroids and there was no worsening of the systemic condition, it is reasonable to assume that the optochiasmatic tuberculomas resulted from a paradoxical reaction. It is important to recognize this condition and initiate prompt treatment to reduce visual morbidity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/jamaophthalmol.2013.4840 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Neuro-Ophthalmology of Tuberculosis.
Neuroophthalmology
November 2023
Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Tuberculosis (TB) is a global health concern and central nervous system (CNS) TB leads to high mortality and morbidity. CNS TB can manifest as tubercular meningitis, tuberculoma, myelitis, and arachnoiditis. Neuro-ophthalmological involvement by TB can lead to permanent blindness, ocular nerve palsies and gaze restriction.
View Article and Find Full Text PDFExtensive Vasculitis in Tuberculous Meningitis.
J Glob Infect Dis
August 2023
Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Tuberculous meningitis causes substantial morbidity and mortality in tropical countries. The various complications reported are hydrocephalus, vasculitic infarcts, tuberculomas, abscesses, and optochiasmatic arachnoiditis. Vasculitis in tuberculosis is basically at the level of lenticulostriate arteries supplying the basal ganglia and terminal cortical branches.
View Article and Find Full Text PDFOptochiasmatic Tuberculoma and Arachnoiditis as a Paradoxical Reaction to Antituberculous Treatment.
J Neuroophthalmol
December 2024
Neuro-Ophthalmology Division (WB, HS), Service of Ophthalmology, Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland ; Neuroradiology Division (MIV), Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland; Pneumology Division (GK, J-PJ), Geneva University Hospitals, Geneva, Switzerland; Department of Neurosurgery (MVC), Geneva University Hospitals, Geneva, Switzerland; Neurosurgery Division (MVC), Department of Neuroscience, Rennes University Hospitals, Rennes, France; Laboratoire de traitement de signal (MVC), Groupe Medicis, INSERM UMR 1099, University of Rennes I, Rennes, France; Neurology Division (CB), Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland; and Department of Neurosurgery (TRM), The National Hospital of Denmark, Copenhagen, Denmark.
Effectiveness of Adjunctive High-Dose Infliximab Therapy to Improve Disability-Free Survival Among Patients With Severe Central Nervous System Tuberculosis: A Matched Retrospective Cohort Study.
Clin Infect Dis
November 2023
Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India.
Background: Few treatment options exist for patients with severe central nervous system (CNS) tuberculosis (TB) worsening due to inflammatory lesions, despite optimal antitubercular therapy (ATT) and steroids. Data regarding the efficacy and safety of infliximab in these patients are sparse.
Methods: We performed a matched retrospective cohort study based on Medical Research Council (MRC) grading system and modified Rankin Scale (mRS) scores comparing 2 groups of adults with CNS TB.
Neurotuberculosis: an update.
Acta Neurol Belg
February 2021
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Tuberculous (TB) meningitis (TBM), accounting for 70-80% of cases of neurotuberculosis, is one of the most severe forms of extrapulmonary tuberculosis. Two-thirds of new TB cases come from eight countries. Polymorphisms in toll-interleukin-1 receptor domain and in leukotriene A4 hydrolase (LTA4H) gene, affect the risk of inflammation in TBM.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!