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Journal of Meningitis
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  • Research Article   
  • J Meningitis 2016, Vol 1(1): 107
  • DOI: 10.4172/2572-2050.1000107

Visual Impairment in HIV Negative Tuberculosis Meningitis

Asad Abbas1, Rakesh Shukla1*, Ramesh C Ahuja2, Rakesh K Gupta3, Komal D Singh4 and Sandeep Saxena4
1Department of Neurology, King Georges Medical University, Lucknow, India
2Department of Medicine, King Georges Medical University, Lucknow, India
3Department of Radio Diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, , Lucknow, India
4Department of Ophthalmology, King Georges Medical University, Lucknow, India
*Corresponding Author : Rakesh Shukla, Department of Neurology, King Georges Medical University, Lucknow, Uttar Pradesh, India, Tel: 0522- 2257090, Email: [email protected]

Received Date: Dec 30, 2015 / Accepted Date: May 18, 2016 / Published Date: May 25, 2016


Objective: Visual impairment is a common problem in tuberculous meningitis (TBM). Present study has been conducted to evaluate the prevalence of visual impairment at presentation and at 3 months.

Methods: Twenty seven consecutive HIV negative patients with TBM were included. Visual acuity, colour vision, field of vision, and visual evoked potentials (VEP) were recorded at baseline and at 3 months. The criteria for visual impairment were: visual acuity <6/12 and <N/10, defective color vision, and visual field abnormality either alone / in combination. Fundus was examined by a single examiner using slit lamp biomicroscopic examination with 90 D lens and by indirect ophthalmoscopy with 2.2D lens.

Results: Twelve patients out of 27 had visual impairment at presentation and the causes were optochiasmatic arachnoiditis (n=6), optic atrophy (n=2), occipital infarct (n=1) and unremarkable (n=3). Three patients showed improvement in visual acuity, 6 patients had no change and 3 patients expired at 3 months. On multivariate analysis papilloedema, optic atophy, temporal disc pallor and hydrocephalus were predictors of visual impairment at 3months (p< 0.001 ).

Conclusion: Visual impairment in TBM is observed in half the patients. It may be predicted by the presence of hydrocephalus on computerized tomography (CT)/ magnetic resonance imaging (MRI), while a simple bedside fundus examination can predict the visual impairment at three months. VEP helps in detecting sub-clinical visual impairment.

Keywords: Tuberculous meningitis; Opticatrophy; Optochiasmatic arachnoiditis; Visual impairment; Visual evoked potentials

Citation: Abbas A, Shukla R, Ahuja RC, Gupta RK, Singh KD, et al. (2016) Visual Impairment in HIV Negative Tuberculosis Meningitis. J Meningitis 1:107. Doi: 10.4172/2572-2050.1000107

Copyright: ©2016 Abbas A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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