Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS

Lancet Infect Dis. 2016 Apr;16(4):493-9. doi: 10.1016/S1473-3099(15)00269-8. Epub 2016 Feb 18.


Choroidal tuberculosis is present in 5-20% of patients with disseminated tuberculosis, and point-of-care dilated binocular indirect ophthalmoscopy eye examination can provide immediate diagnosis. In geographical areas of high tuberculosis prevalence and in susceptible patients (CD4 counts less than 200 cells per μL) detection of choroidal granulomas should be accepted as evidence of disseminated tuberculosis. With training and proper support, eye screening can be done by HIV/AIDS clinicians, allowing early tuberculosis treatment. In regions with a high burden of tuberculosis, we recommend that eye screening be a standard part of the initial assessment of susceptible patients, including at a minimum all patients with HIV/AIDS with CD4 less than 100 cells per μL with or without eye symptoms, and with or without suspicion of disseminated tuberculosis.

Publication types

  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / microbiology
  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / microbiology
  • Choroid Diseases / diagnosis*
  • Choroid Diseases / microbiology
  • Early Diagnosis
  • Eye / microbiology
  • Granuloma / diagnosis*
  • Granuloma / microbiology
  • Humans
  • Ophthalmoscopy
  • Optic Disk / pathology
  • Point-of-Care Systems
  • Prevalence
  • Tuberculosis / complications
  • Tuberculosis / diagnosis*
  • Tuberculosis / microbiology
  • Tuberculosis, Ocular / complications
  • Tuberculosis, Ocular / diagnosis
  • Tuberculosis, Ocular / microbiology