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  • 1.  TB testing in optic neuritis

    Posted 08-18-2025 07:24
    At a meeting of Controversies in Ophthalmology in April of this year in Spain, Andy Lee and Dan Milea presented cases of optic neuritis and asked if TB testing is done. They both stated that in India, yes, in US and Paris, no. 
    I rest my case. Apologies accepted.
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    Scott Forman, MD
    Senior Fellow North American Neuro-ophthalmology Society

    Adult and Pediatric Neuro-ophthalmology
    Comprehensive Ophthalmology
    Functional Medicine











  • 2.  RE: TB testing in optic neuritis

    Posted 08-18-2025 08:14
    Here in Egypt the answer is yes in suspected cases , I noticed sort of increased frequency of the disease I don't know about the rest of Africa or ME 





  • 3.  RE: TB testing in optic neuritis

    Posted 08-19-2025 00:12
    In El Paso TX the answer is yes. Quantiferon gold for atypical cases, always.


    Original Message


  • 4.  RE: TB testing in optic neuritis

    Posted 08-19-2025 07:14
    And how many positives have you had in the past 5 years?
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    Scott Forman, MD
    Senior Fellow North American Neuro-ophthalmology Society

    Adult and Pediatric Neuro-ophthalmology
    Comprehensive Ophthalmology
    Functional Medicine












    Original Message


  • 5.  RE: TB testing in optic neuritis

    Posted 08-19-2025 08:34
    For me hard to count because of the Manz places I go besides my clinic , but I think if I say once a month it could b close but I see high traffic places so this is probably less than 1% of cases of optic neuritis that I see 





    Original Message


  • 6.  RE: TB testing in optic neuritis

    Posted 08-19-2025 18:48
    2 positives (and treated accordingly) within the last 2 years

    ... it is valid to say that ID specialists need a lot of evidence-convincing that the "Eye findings" are TB related and therefore pt needs systemic treatment 





    Original Message


  • 7.  RE: TB testing in optic neuritis

    Posted 08-20-2025 05:13
    I I said one case per month this includes already diagnosed cases for consultation and also included Cases of TB meningitis , so probably cases that were discovered from optic nerve affection are probably less  in incidence 





    Original Message


  • 8.  RE: TB testing in optic neuritis

    Posted 08-18-2025 09:31
    The TB tests like X-ray chest and Mantoux are done as a part of atypical optic neuritis work up, but I concede that it was the likes of NMO and MOG optic neuritis which we were treating as TB optic neuritis ( when the mantoux was positive or the chest imaging showed fibrosis indicative of past TB infection)some years back.
    Now it’s either MSON/NMO/MOG/Double negative . It’s been a while I diagnosed a case of TB ON
    But we continue to work them for TB , if any of the tests hint towards TB , take the ID specialists opinion to give an ATT cover as immunosuppressives/steroid can wreak havoc in TB any where in the body, neuritis or no neuritis .

    Dr Shikha Bassi
    Sankara Nethralaya
    Chennai
    India




  • 9.  RE: TB testing in optic neuritis

    Posted 08-19-2025 15:52
    Here in New Zealand. Yes, in atypical optic neuritis 
    There is a tread of increasing cases of TB in general as NZ society has mixed background.
    Selma Matloob
    Neurophthalmologist
    Hamilton, Mew Zealand 

    Sent from my iPhone



    Original Message


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