Visual Impairment in HIV Negative Tuberculosis Meningitis
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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