Presumed tuberculosis-induced retinal vasculitis, diagnosed with positron emission tomography (18F-FDG-PET/CT), aspiration biopsy, and culture

Ocul Immunol Inflamm. 2010 Jun;18(3):194-9. doi: 10.3109/09273948.2010.483318.


Purpose: The diagnosis of tuberculosis as an etiological factor in patients with uveitis is difficult because of lack of specific diagnostic tests. The authors report 2 cases of occlusive retinal vasculitis, in which (18)F-FDG-PET/CT was helpful for the diagnosis of tuberculosis as a presumptive cause of intraocular inflammation.

Methods: In 2 patients with severe occlusive retinal vasculitis and positive QuantiFERON TB-Gold test, (18)F-FDG-PET/CT, transbronchial needle-aspiration biopsy, and microbiological investigation were performed.

Results: (18)F-FDG-PET/CT showed increased fluorodeoxyglucose uptake in some mediastinal and hilar lymph nodes. After needle-aspiration biopsy of PET-positive lymph nodes, M. tuberculosis was recovered in culture in both cases. Remission of uveitis was achieved only after a combination therapy with 3 anti-tubercular agents and systemic steroids.

Conclusion: The authors favor the use of (18)F-FDG-PET/CT in patients with sight-threatening intraocular inflammation and positive interferon-gamma release assay. Anti-tubercular therapy, together with anti-inflammatory treatment, may lead to a remission in such patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy, Needle / methods*
  • DNA, Bacterial / analysis
  • Diagnosis, Differential
  • Fluorescein Angiography
  • Fluorodeoxyglucose F18*
  • Fundus Oculi
  • Humans
  • Lymph Nodes / microbiology
  • Lymph Nodes / pathology
  • Male
  • Mediastinum
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification*
  • Polymerase Chain Reaction
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Retinal Vasculitis / diagnosis*
  • Retinal Vasculitis / microbiology
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / microbiology


  • DNA, Bacterial
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18