A Particular Use Of Amniotic Membrane In A Rare Situation

 Tuberculosis (TB) remains a global public health issue with nearly 8 million new cases per year and more than 1 million deaths per year.1 Ocular TB with a mean prevalence of about 6.8% can be observed in nearly every ocular structure resulting in a variety of vision-threatening complications, such as phlyctenulosis, granulomatous uveitis with synechiae formation, vitritis, posterior uveitis, panuveitis, retinitis, and retinal vein occlusion as well as choroidal and scleral tuberculoma.Overall, cases of secondary keratitis with underlying TB are rare .

Ophthalmology deprtement, Mohammed VI univeristy Hospital, Oujda , Morocco

Methods: To report a case of autoimmune keratitis in a patient with mycobacterium tuberculosis (MBT). 

 a 63 old patient , monophthalmus, was initially admitted for unilateral granulomatous synechial panuveitis due to documented infection by MBT. after 6 months of treatement ( Anti MBT treatement an local and general corticotherapy with degression) , he presented wiith an unilatreal painful red eye with vidual acuity to CF, corneal oedema , big marignal ulcerative keratitis. The evolution was good under local and general cortiotherapy. We chosed to use an amniotic membrane graft to help the corneal healing by grafting on an inlay position , we obtained a clear central cornea with a BVCA at 0.2 and a satisfied patient.

In conclusion, the present report demonstrates that MBT is able to initiate a delayed autoimmune response within the conjunctival and corneal tissue even after the end of of anti-tuberculosis treatment. Therefore, ocular TB should be considered in the differential diagnosis of chronic, atypical ulcerative, or interstitial keratitis. Amniotic membrane propreties should be considered in these situtation to help regeneration and VA gain.