Tuberculosis Uveitis—Consumed by Uncertainty

Uveitis caused by Mycobacteria tuberculosis remains difficult to diagnose and difficult to treat. Even the recognized tuberculosis uveitis (TBU) phenotypes (choroidal granuloma, retinal vasculitis, serpiginous chorioretinopathy, and granulomatous chronic anterior uveitis) are diverse and not specific to tuberculosis, but tuberculosis can present with almost any uveitic phenotype. The tuberculin skin test (TST) and interferon-γ reactivity assay (IGRA) tests for tuberculosis infection only indicate exposure to tuberculosis and currently provide no information on whether the tuberculosis is active or the cause of the uveitis. If active tuberculosis is known or discovered in the lungs or another site that is amenable to biopsy or culture, this is extremely helpful but is often not present.

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