Tuberculosis of the Central Nervous System by Mehmet Turgut Ali Akhaddar Ahmet T. Turgut & Ravindra K. Garg

Author:Mehmet Turgut, Ali Akhaddar, Ahmet T. Turgut & Ravindra K. Garg
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

22.5.2 Diagnosis of Optochiasmatic Tuberculosis

First clue to OCA or OCT is vision impairment, and complete visual assessment is an integral part of diagnosis of OCA. Radiological and histopathological features also support OCA diagnosis.

22.5.2.1 Visual Assessment

Visual complains of a patient is the first clue to OCA. Clinical examination includes visual acuity and fundus examination. Field charting can be done to ascertain the type of scotoma and field defects. Classical patterns of optic chiasm involvement is lacking as the arachnoiditis is a diffuse process involving chiasm, optic nerve, and to some extent optic tracts too. Fundus photography and OCT help in evaluation of retinal layers. Visual evoked potential is another modality to assess the visual pathway and is usually abnormal in OCA. Prospective study evaluating these parameters in OCA is lacking, and available literature such as case reports and case series [17, 87, 88, 90] mentions only visual acuity or field defects.

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