An individual approach to the diagnosis of uveitis of tuberculous etiology: from theory to practice

Intraocular tuberculosis is a great mystifier of various forms of uveitis, and it should be put in the first row in the differential diagnosis of any type of intraocular inflammation, as well as clearly differentiate it from other etiologies of choroidal lesions, which presents certain difficulties due to the diversity, mosaic, and often atypical clinic of the tuberculosis process. The article presents a clinical observation of tuberculous uveitis in a 61-year-old patient D., which was well stopped by nonspecific anti-inflammatory therapy and antibacterial drugs. When conducting and evaluating the results of additional studies, such as computed tomography of the chest and a highly specific TSPOT.TB test, the patient was suspected to have a latent tuberculosis infection in the patient. As a result, a test with recombinant tuberculosis allergen (ATR) was performed, as a result of which the authors received a pronounced focal reaction from the eye. Thus, for the first time in the world scientific community, a clinical picture of a pronounced reaction of the eye to an ATR test is presented, since at the moment there is no information among the available sources of domestic and foreign literature that describes the same reaction to an ATR test as in the presented clinical example. The authors note that the eccentricity of the course of tuberculosis of the visual analyzer obliges the doctor to correctly collect an anamnesis, choose current diagnostic methods, correctly evaluate their results and evaluate the effectiveness of anti-tuberculosis therapy.