Observed Patterns of Systemic Disease on PET/CT Scan in Patients with Presumed Ocular Tuberculosis: Findings and Hypotheses.

Purpose: To report the clinical, investigational and PET/CT scan findings of patients with presumed ocular tuberculosis and suggest a hypotheses for the pathogenesis.

Methods: Retrospective case review. Included were 10 males and 17 females with an age range: 23-71 years.

Results: Clinical findings include granulomatous or non-granulomatous anterior uveitis, intermediate uveitis, panuveitis, vasculitis, and multifocal serpiginous-like choroidopathy. A total of 13 PET/CT scans were normal and 14 showed systemic disease. The commonest finding was metabolically active lymphadenopathy and was seen in 14 patients. Mediastinal lymphadenitis was seen in 12 patients, 3 patients had abdominal/pelvic lymphadenopathy and 3 patients had additional cervical lymphadenopathy. Two patients had only cervical lymphadenitis. One patient had lung parenchymal disease and one had bone/joint disease. The commonest pathology was lymphadenitis.

Conclusions: Uveitis is part of an immune response to mycobacteria that manifests as lymphadenitis in the chest/abdomen and as a uveitis.