Abstract:

Objective: To explore the effect of anti-neovascular endothelial growth factor therapy in patients of tuberculous chorioretinopathy with choroidal neovascularization in intraocular tuberculosis. Methods: A 17-year-old girl with intraocular tuberculosis and systemic tuberculosis infection admitted to Hebei Chest Hospital in February 2019 was retrospectively analyzed, including the improvement of various indicators and the improvement of macular tuberculosis. PubMed database was searched using “ocular tuberculosis” and “choroidal neovascularization” as keywords; Wanfang, VIP and CNKI were searched using “ocular tuberculosis” and “choroidal neovascularization” as the search terms. Review the retrieved literature, symptoms, diagnosis, treatment of tuberculous chorioretinopathy and treatment measures of choroidal neovascularization were analyzed. Results: The 17-year-old patient was female, with the main manifestation of unclear vision in the right eye for 4 months. She was first diagnosed in the Ophthalmology Department of Hebei Chest Hospital. After questioning the medical history, it was found that she had systemic symptoms such as intermittent low fever, cough and headache. It was strong positive in the tuberculin skin test, positive in the gamma interferon release test, and the final diagnosis was acute hematogenous disseminated pulmonary tuberculosis, tuberculous meningitis, choroidal tuberculoma in the right eye with choroidal neovascularization and choroidal nodule in the left eye. In view of the tuberculous uveitis, 17 relevant literatures were retrieved, including 2 literatures of intraocular tuberculosis combined with choroidal neovascularization. A total of 9 patients were included. The fundus lesions were observed by optical coherence tomography. Three patients improved after simple anti-neovascularization intravitreal therapy, but recurrent. Nine patients underwent systemic anti-tuberculosis treatment and combined treatment of corticosteroids and anti-neovascularization, there was no recurrence or deterioration of intraocular tuberculosis and choroidal neovascularization. Conclusion: Standard treatment of intraocular tuberculosis patients complicated with choroidal neovascularization requires a combination of systemic anti-tuberculosis drugs, corticosteroids, and local intravitreal injection of anti-vascular endothelial growth factor, which can effectively control the infection and the development of tuberculous choroidal neovascularization. After standardized treatment, the recovery of anatomy and function of fundus lesions can avoid blindness caused by intraocular tuberculosis.

Key words: Tuberculosis,ocular, Signs and symptoms, Review literature as topic, Consensus development conferences as topic