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B. Yanez, A. Cerrate, B. Campos, C. Siverio; Ocular Tuberculosis: ADA as a Parameter for Activity. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2895.
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© ARVO (1962-2015); The Authors (2016-present)
To describe ophthalmologic findings associated to tuberculosis (TBC) and report the usefulness of adenosine deaminasa (ADA) in ocular fluids as a parameter for TBC activity.
This is a retrospective review of charts of 59 patients evaluated at the Uveitis Unit of Ocular National Institute (INO), Peru, from January 2000 to April 2008. The diagnosis was based in clinical findings, pathologic chest x-rays, positive Mantoux skin test more of10mm of induration, ADA aqueous humor test (positive > 6UI/L) and response to treatment.
There were 30 males and 29 females. All were immunocompetent. The range of age was 3 - 71 years, media 40 years. 76 eyes were involved. 97% had active ocular disease. It was bilateral in 17 patients. They had pulmonar TBC history in 22% and ocular TBC in 3%. Anormal chest x-rays 34% and positive Mantoux skin test 68%. Twenty three eyes with intraocular TBC had ADA aqueous humor test and it was positive in 57%. ADA test values were in range of 6.4-63 UI/L, media 18 UI/L. Forty nine patients received anti-tuberculosis drugs. Ocular findings were iridocyclitis 58%, choroiditis 31%, scleritis 25% and vitreitis 24%. Ocular complications were cystoid macular edema 13%, epiretinal membrane 8% and panophthalmia 7%. These findings were associated with < 20/200 visual acuity in 20% of the eyes with severe intraocular TBC.
ADA test was positive in 57% of eyes with intraocular TBC. This intraocular fluid test can be used to support the diagnosis of ocular tuberculosis.
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