A Case of Bilateral Orbital Tuberculosis

Hyun Min Ahn; Jeong Hae Kie; Hye Young Kim

doi:10.3341/jkos.2017.58.7.862

Journal List > J Korean Ophthalmol Soc > v.58(7) > 1010819

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Ahn, Kie, and Kim: A Case of Bilateral Orbital Tuberculosis

Case Report

J Korean Ophthalmol Soc 2017;58(7):862-865.

Published online: 4 February 2017

DOI: https://doi.org/10.3341/jkos.2017.58.7.862

A Case of Bilateral Orbital Tuberculosis

Hyun Min Ahn, MD^1,², Jeong Hae Kie, MD³, Hye Young Kim, MD^2,³

¹Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

²Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea

³Department of Pathology, National Health Insurance Service Ilsan Hospital, Goyang, Korea

^* This study was presented as a poster at the 116th Annual Meeting of the Korean Ophthalmological Society 2016.

^* Conflicts of Interest: The authors have no conflicts to disclose.

Received 11 May 2017 Revised 28 May 2017 Accepted 22 June 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Periocular tuberculosis is common in the form of conjunctival tuberculosis or uveitis; however, orbital tuberculosis is very rare. We report a case of tuberculosis diagnosed based on bilateral orbital masses.

Case summary

A 64-year-old male with a history of diabetes, hypertension, and chronic obstructive pulmonary disease presented with diplopia. His best-corrected visual acuity was 1.0, and intraocular pressure was 16 mmHg in both eyes. Bilateral proptosis was noted, and inferior orbital masses were palpated in both eyes. On orbital computed tomography, irregular masses were surrounding both globes in the extraconal space. Incisional biopsy of the bilateral orbital masses was performed under local anesthesia. Pathologic examination revealed chronic granulomatous inflammation accompanied by caseous necrosis. The patient was diagnosed with bilateral orbital tuberculosis and underwent triple therapy with isoniazid, rifampin, and ethambutol for 12 months. The orbital masses completely resolved, and there was no recurrence or complication through 12 months after treatment.

Conclusions

To our knowledge, bilateral orbital tuberculosis has not been reported yet. Herein, we report a case of orbital tuberculosis presenting as bilateral orbital masses. J Korean Ophthalmol Soc 2017;58(7):862–865

Keywords: Orbital inflammation, Orbital mass, Orbital tuberculosis, Tuberculosis

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Figure 1.

Initial contrast enhanced orbital computed tomography scan. Ill-defined irregular masses (arrows) were noted in both orbits. The masses were located in extraconal space and surrounding the eyeball (A, Coronal view; B, Axial view).

Figure 2.

Histopathologic examination. Granulomatous inflammation with central geographic necrosis is observed. A Langhans-type giant cell (arrow) is noted (H&E, ×200).

Figure 3.

Nine-month post-treatment orbital computed tomography scan. There was no evidence of residual or recurred orbital tuberculosis (A, Coronal view; B, Axial view).

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