Skip to main content

Advertisement

SpringerLink
Log in

Orbital tuberculosis: perspectives from Victoria, Australia

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Orbital tuberculosis (TB) is a rare extra-pulmonary manifestation of tuberculosis and its clinical diagnosis poses unique challenges, with potential for destructive complications as well as social and public health implications. The aim of this study is to report our experience of patients presenting with orbital TB and to identify common aspects.

Methods

A systematic search for mandatory notifications of orbital tuberculosis between January 01, 1994 and December 12, 2016 was undertaken in the Victorian Tuberculosis database. In addition, members of the Australian and New Zealand Society of Ophthalmic Plastic Surgeons (ANZSOPS) were surveyed to identify cases of orbital tuberculosis diagnosed on biopsy in the past 20 years. Medical case notes of identified cases were reviewed retrospectively.

Results

Three cases were identified as having occurred in Victoria, aged 44–59 years old. All cases had emigrated from endemic countries with higher tuberculosis burden. Diagnosis of tuberculosis was often difficult due to few or non-viable acid fast bacilli and low yield of positive culture in paucicellular orbital specimens.

Conclusions

Orbital TB is rare but remains an important differential diagnosis of orbital mass lesions. The diagnosis of orbital TB requires a high index of clinical suspicion and targeted investigations in patients originating from endemic areas. Diagnosis and treatment rely on effective collaboration between ophthalmologists, infectious disease physicians, and pathologists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Madge SN, Prabhakaran VC, Shome D, Kim U, Honavar S, Selva D (2008) Orbital tuberculosis: a review of the literature. Orbit 27:267–277

    Article  Google Scholar 

  2. Babu K, Mukhopadhyay M, Bhat SS, Chinmayee J (2014) Orbital and adnexal tuberculosis: a case series from a South Indian population. J Ophthalmic Inflamm Infect 4:12–18

    Article  Google Scholar 

  3. Dalvin LA, Smith WM (2016) Orbital and external ocular manifestations of Mycobacterium tuberculosis: a review of the literature. J Clin Tuberc Other Mycobact Dis 4:50–57

    Article  Google Scholar 

  4. Hughes EH, Petrushkin H, Sibtain NA, Stanford MR, Plant GT, Graham EM (2008) Tuberculous orbital apex syndromes. Br J Ophthalmol 92:1511–1517

    Article  CAS  Google Scholar 

  5. Dale KD, Tay EL, Trauer JM, Trevan PG, Denholm JT (2017) Comparing tuberculosis management under public and private healthcare providers: Victoria, Australia, 2002–2015. BMC Infect Dis 17:324

    Article  Google Scholar 

  6. WHO Global TB Report Author Group (2016) WHO global tuberculosis report 2016: key TB indicators. World Health Organisation. http://www.who.int/tb/publications/global_report/en/. Accessed May 2017

  7. Toms C, Stapledon R, Waring J, Douglas P et al (2015) 2012 and 2013: tuberculosis notifications in Australia annual report. Australian Government. http://www.health.gov.au/internet/main/publishing.nsf/content/cda-pubs-annlrpt-tbannrep.htm. Accessed June 2017

  8. Salam T, Uddin JM, Collin JRO, Verity DH, Beaconsfield M, Rose GE (2015) Periocular tuberculous disease: experience from a UK eye hospital. Br J Ophthalmol 99:582–585

    Article  Google Scholar 

  9. Benech N, Jouanneau E, Chidiac C, Ferry T (2016) Orbital granuloma: a rare manifestation of extrapulmonary tuberculosis. BMJ Case Reports. https://doi.org/10.1136/bcr-2016-214542

  10. Sen DK (1980) Tuberculosis of the orbit and lacrimal gland: a clinical study of 14 cases. J Pediatr Ophthalmol Strabismus 17:232–238

    CAS  PubMed  Google Scholar 

  11. Kaur A, Kant S, Bhasker SK (2007) Periorbital tuberculosis. Orbit 26:39–42

    Article  Google Scholar 

  12. Agrawal PK, Nath J, Jain BS (1977) Orbital involvement in tuberculosis. Indian J Ophthalmol 25:12–16

    CAS  PubMed  Google Scholar 

  13. Tanawade RG, Thampy RS, Wilson S, Lloyd IC, Ashworth J (2015) Tuberculous orbital apex syndrome with severe irreversible visual loss. Orbit 34:172–174

    Article  Google Scholar 

  14. Lee JY (2015) Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis 78:47–55

    Article  Google Scholar 

  15. Hillemann D, Rusch-Gerdes S, Boehme C, Richter E (2011) Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. J Clin Microbiol 49:1202–1205

    Article  CAS  Google Scholar 

  16. Victoria State Government (2017) Notifiable diseases. https://www2.health.vic.gov.au/public-health/infectious-diseases/notify-condition-now. Accessed May 2017

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Austin Health, Heidelberg, Victoria, Australia

    Anthony Yao & Jwu Jin Khong

  2. Department of Infectious Diseases, St Vincent’s Hospital, Fitzroy, Victoria, Australia

    Craig Aboltins

  3. Orbital, Plastics and Lacrimal Unit, The Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, VIC, Australia

    Alan A. McNab & Jwu Jin Khong

  4. Centre for Eye Research Australia, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia

    Alan A. McNab & Jwu Jin Khong

  5. Department of Anatomical Pathology, St Vincent’s Hospital, Fitzroy, Victoria, Australia

    Cesar Salinas-La Rosa

  6. Victorian Tuberculosis Program, Melbourne Health, Melbourne, Victoria, Australia

    Justin Denholm

  7. Department of Microbiology and Immunology at the Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia

    Justin Denholm

Authors
  1. Anthony Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Craig Aboltins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alan A. McNab
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cesar Salinas-La Rosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Justin Denholm
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jwu Jin Khong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jwu Jin Khong.

Ethics declarations

The study was approved by the Royal Victorian Eye and Ear Hospital Human Research and Ethics Committee.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yao, A., Aboltins, C., McNab, A.A. et al. Orbital tuberculosis: perspectives from Victoria, Australia. Graefes Arch Clin Exp Ophthalmol 256, 2443–2448 (2018). https://doi.org/10.1007/s00417-018-4099-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-018-4099-1

Keywords

Search

Navigation