Clinical spectrum of tuberculous optic neuropathy

E Davis, S Rathinam, A Okada, S Tow, H Petrushkin, E Graham, S Chee, Y Guex-Crosier, E Jakob, I Tugal-Tutkun, E Cunningham, J Leavitt, A Mansour, K Winthrop, W Hills, Justine Smith

    Research output: Contribution to journalArticlepeer-review

    37 Citations (Scopus)


    Purpose: Tuberculous optic neuropathy may follow infection with Mycobacterium tuberculosis or administration of the bacille Calmette-Guerin. However, this condition is not well described in the ophthalmic literature. Methods: Ophthalmologists, identified through professional electronic networks or previous publications, collected standardized clinical data relating to 62 eyes of 49 patients who they had managed with tuberculous optic neuropathy. Results: Tuberculous optic neuropathy was most commonly manifested as papillitis (51.6 %), neuroretinitis (14.5 %), and optic nerve tubercle (11.3 %). Uveitis was an additional ocular morbidity in 88.7 % of eyes. In 36.7 % of patients, extraocular tuberculosis was present. The majority of patients (69.4 %) had resided in and/or traveled to an endemic area. Although initial visual acuity was 20/50 or worse in 62.9 % of 62 eyes, 76.7 % of 60 eyes followed for a median of 12 months achieved visual acuities of 20/40 or better. Visual field defects were reported for 46.8 % of eyes, but these defects recovered in 63.2 % of 19 eyes with follow-up. Conclusion: Visual recovery from tuberculous optic neuropathy is common, if the diagnosis is recognized and appropriate treatment is instituted. A tuberculous etiology should be considered when evaluating optic neuropathy in persons from endemic areas.

    Original languageEnglish
    Pages (from-to)183-189
    Number of pages7
    JournalJournal of Ophthalmic Inflammation and Infection
    Issue number4
    Publication statusPublished - Dec 2012


    • Optic neuropathy
    • Presentation
    • Tuberculosis
    • Visual outcome


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