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S. Yashiro, A. Uemura, N. Takeda, E. Toyoda, K. Kudo; Ophthalmologic involvement in patients with active systemic tuberculosis . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1677.
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Purpose: To evaluate the incidence of ophthalmologic complications, especially in uveitis and diabetic retinopathy in active tuberculosis patients. Methods : One–year prospective cohort study between January and December 2002 was carried out at International Medical Center of Japan. Patients in the isolation ward with active pulmonary tuberculosis were eligible for the study. Results: One hundred ninety–two patients (median 46.7 years, range 17–89) were included. Corneal opacity with ghost vessels was seen in 1 eye (0.3%) of 1 patient. Uveitis was found in 32 eyes (8.3%) of 21 patients. The details of the uveitis were following; anterior uveitis in 2 eyes (0.5%), single choroiditic focus in 2 eyes (0.5%), multifocal choroiditis or the scar in 19 eyes (4.9%), and focal retinal vasculitis in 18 eyes (4.6%) . These findings were seen overlapped among the patients. Patients with retinal vasculitis were all under age of 30. None of the findings were severe and needed any treatment except for anti–tuberculosis drugs. Fifty–six patients (29.2%) had diabetes mellitus, and 32 eyes (8.3%) of 18 patients had diabetic retinopathy. Eight eyes (2.1%) of 4 patients required ocular treatment; six eyes (1.6%) of 3 patients had pre–proliferative retinopathy and 2 eyes (0.5%) of 1 patient had proliferative retinopathy. Conclusions: Although uveitis in tuberculosis is well known, we also should recognize the high prevalence of diabetes mellitus and necessity of ocular treatments for diabetic retinopathy in active tuberculosis patients.
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