Clinical and laboratory features of PCR-confirmed periocular tuberculosis in China

• Published in: International journal of ophthalmology Vol. 11; no. 11; pp. 1865 - 1869
• Main Authors: Ma, Rui-Qi, Gan, Lu, Bi, Ying-Wen, Yuan, Yi-Fei, Ren, Hui, Qian, Jiang
• Format: Journal Article
• Language: English
• Published: China International Journal of Ophthalmology Press 18.11.2018; Press of International Journal of Ophthalmology (IJO PRESS)
• Subjects: acid-fast bacilli staining; Brief Report; caseous necrosis; Langhans giant cell; lymphocyte; nested polymerase chain reaction; periocular tuberculosis; periocular tuberculosis; nested polymerase chain reaction; Langhans giant cell; acid-fast bacilli staining; caseous necrosis; lymphocyte
• ISSN: 2222-3959; 2227-4898
• DOI: 10.18240/ijo.2018.11.20

Experts lack knowledge of periocular tuberculosis (TB) in China. Nested polymerase chain reaction (PCR) shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungal-TB panophthalmitis. Sensitivity of caseous necrosis, acid-fast bacilli (AFB) staining and interferon γ release assay (T-SPOT) test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage ( =0.019) and high monocyte-lymphocyte ratio ( =0.042) positively correlate with AFB staining. Male gender ( =0.048) and Langhans giant cell ( =0.048) positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.