What happens when oral tuberculosis is not treated?

Pulmonary tuberculosis (TB) is the most important form of the disease, although infection may also occur by way of the intestinal tract, tonsils and skin. Oral lesions consist of persistent ulcers or granulomatous masses. A 50 year old man had been diagnosed “necrotising granulomatous inflammation” following a biopsy of a lesion on lower lip, 21 months before at a medical centre. A chest-X-ray had not been performed and he had not been given any advise in respect of treatment. He was admitted to the hospital with cough, sputum, weakness, weight loss and lesions on his lower lip. In radiology, it was detected that he had supraclavicular, submental, cervical, mediastinal lymphadenopathies, pulmonary infiltrations with cavities, thickening and roughness on left oropharengial tonsil, thickenning on inner parts of larynx and bilateral surrenal thickening. The biopsy of lesions on larynx, tonsil and epiglottis revealed “necrotising granulomatous inflammation” and histopathology supported TB infection. Sputum acid-fast bacilli was positive and culture was positive for Mycobacterium tuberculosis complex. Two months of combination treatment resulted in a gradual relief of the symptoms, radiological response, disappearing of neck swelling and healing of lesions on lip, tonsil and larynx. Although unusual oral cavity manifestations of TB are rare, clinicians should be aware of possible occurrance

Clinical, angiographic, optic coherence tomographic and electrophysiological findings in Bietti's crystalline dystrophy [Bietti'nin Kristalin Distrofisinde Klinik, Anjiyografik, Optik Koherans Tomografik ve Elektrofizyolojik Bulgular]

To present the characteristic clinical, angiographic, electrophysiologic and optic coherence tomographic findings in eight patients with Bietti's crystalline dystrophy. Material and Methods: All patients had detailed ophthalmologic examination. Visual field examination, fluorescein angiography, electroretinography, electrooculography recordings, and optic coherence tomography were performed in all patients. Results: Best-corrected visual acuity ranged from 2/10 to 10/10. On fundoscopic examination, the reflective yellow deposits located especially in the posterior pole of the retina with the mottling of retina pigment epithelium were seen in all patients whereas in some of the cases pigment deposition, retina pigment epithelium and choriocapillaris atrophy were also noted. Corneal crystals were observed in the limbus in three cases. Central and paracentral scotomas were detected in perimetric examination. Arden ratios in electrooculography and the results of electroretinography recordings were different. Fluorescein angiography showed island like hypoflourescence corresponding to the geographic areas of retinal pigment epithelium and choriocapillary atrophy in the posterior pole. In addition to this fluorescein angiographic findings, in diffuse type cases, diffuse hypofluorescence that extended to the midperiphery was detected. Optic coherence tomographic examination disclosed multiple hyperreflective lesions in the retina and acoustic shadowing behind these hyperreflective lesions and a hyperreflective white band. Conclusion: Common characteristics of clinical, angiographic, electrophysiologic and optic coherence tomographic findings in patients with Bietti's crystalline dystrophy were described. © 2012 by Türkiye Klinikleri

Late closure of a stage III idiopathic macular hole after pars plana vitrectomy

A 57-year-old female presented to our hospital with decreased vision in her right eye. Detailed ocular examination was performed, and a macular hole was detected in the right eye. The presence of a full-thickness stage III macular hole was confirmed with optical coherence tomography (OCT) imaging. Pars plana vitrectomy followed by long-acting gas tamponade (C3F8) was performed as treatment. One month after surgery, clinical examination revealed a persistent macular hole, confirmed by an OCT scan. Although the patient was scheduled for reoperation, the surgery was postponed due to personal reasons of the patient. Surprisingly, after five months, a closure pattern with accompanying epiretinal membrane was observed in the macular hole area. The closure of the macular hole was completed without any further intervention 8 months post-surgery. In cases of unclosed macular hole after the first surgery, if a second surgery cannot be performed, follow-up with OCT recommended due to the possibility of spontaneous closure. However, spontaneous closure of a persistent macular hole following PPV is rare, so early diagnosis and surgical repair of unclosed macular holes must remain the primary goal. © 2015, Turkish Ophthalmology Society. All rights reserved

Atypical presentation of choroidal folds: Steroid-induced central serous chorioretinopathy-like maculopathy [Koroidal Katlantıda Atipik Prezentasyon: Steroide Bağlı Santral Seröz Korioretinopati Benzeri Makülopati]

PubMed: 318935952-s2.0-85077359815This article reports a case of choroidal folds and central serous chorioretinopathy-like maculopathy induced by corticosteroid treatment. The patient was a 70-year-old woman who presented with decreased visual acuity in the right eye. She had a history of rheumatoid arthritis and was prescribed 20 mg leflunomide and 16 mg corticosteroid daily. Fundoscopy indicated bilateral macular edema and the presence of choroidal folds. Retinal imaging supported choroidal folds and central serous chorioretinopathy-like maculopathy. Corticosteroid therapy was discontinued, and the patient was followed up. Complete regression of the maculopathy was observed at 8-month follow-up examination. © 2019 by Turkish Ophthalmological Association