[Pediatric ocular tuberculosis: Epidemiological and clinical profile and particular issues regarding treatment].

INTRODUCTION

Tuberculosis remains the third leading cause of infectious disease mortality worldwide. Ocular tuberculosis, though rare, is on the rise, particularly in relation to the HIV/AIDS epidemic. In children, this condition presents a diagnostic challenge due to its clinical polymorphism and the frequent absence of lesions that are accessible for histologic examination.

PURPOSE: To study the epidemiological, clinical, and therapeutic profiles of ocular tuberculosis in children through a case series.

METHODS

This retrospective study includes 78 cases of ocular tuberculosis in HIV-negative children.

RESULTS

A history of tuberculosis exposure was found in 13 cases; extraocular tuberculosis was observed in 34 cases; a palpebral nodule in 6 cases; follicular conjunctivitis in 16 cases; interstitial keratitis in 12 cases; uveitis in 40 cases, including 3 associated with tuberculous meningitis; retinal vascular occlusion in 16 cases; and multifocal choroiditis in 11 cases. Diagnosis was based on tissue biopsy, cerebrospinal fluid culture, and a combination of clinical and ancillary findings.

DISCUSSION: Ocular tuberculosis in children remains a rare entity, often indicative of latent or active tuberculosis infection. Its diagnosis is based on a combination of clinical and laboratory data, with the QuantiFERON-TB Gold® test proving to be useful. Treatment with antitubercular drugs in combination with corticosteroids generally leads to an improvement in visual prognosis.

CONCLUSION

Ocular tuberculosis presents a diagnostic challenge in children. Early and appropriate management can significantly improve the visual prognosis.