Visual Impairment in HIV Negative Tuberculosis Meningitis

Tuberculous meningitis (TBM) is the most common form of meningitis in the developing countries. It still carries a high morbidity and mortality despite the availability of computerised tomography (CT) scan, magnetic resonance imaging(MRI) scan and effective chemotherapy. Several recent studies involving multivariate regression analysis have suggested that stage of TBM, age, focal weakness , cranial nerve palsy and hydrocephalus are significant prognostic factors for a poor outcome at 3 months.

Visual impairment, especially blindness is a devastating outcome of TBM, occurring in 26-72%.

It can occur due to a lesion anywhere in the visual pathway because of the disease process per se, complications occurring during its course or as a result of side effects of the drugs given for its treatment. It may result from papillitis, papilloedema, primary or secondary optic atrophy, optochiasmatic arachnoiditis and occipital infarct . In addition ethambutol toxicity may also contribute to visual impairment. Sub-clinical visual impairment can be detected by visual evoked potentials. Read more.....