Incidence and Risk Factors of Ophthalmic Nerve Palsy in Patients With Tuberculous Meningitis: A Retrospective Study and Literature Review.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2024-11-19 eCollection Date: 2024-12-01 DOI:10.1093/ofid/ofae686

Zhen-Tao Fei, Lu Xia, Yang Yang, Dan Ye, Hua-Rui Liu, Ping Liu, Wei Huang, Feng Li, Xu-Hui Liu

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引用次数: 0

Abstract

Background: Tuberculous meningitis (TBM) can lead to ophthalmic nerve palsy (ONP), a severe neurological complication. This study aims to evaluates the incidence and risk factors for ONP in TBM patients.

Methods: This retrospective study included 250 TBM patients from the Shanghai Public Health Clinical Center (2013-2022). Clinical and imaging data were analyzed, with logistic regression identifying risk factors for ONP.

Results: ONP occurred in 6.8% (17/250) of TBM patients. Those with ONP had higher intracranial pressure (ICP) (257.69 ± 68.12 mmH2O vs 191.65 ± 91.58 mmH2O; P = 0.012), cerebrospinal fluid protein levels, and a higher prevalence of tuberculomas (29.4% vs 10.7%; P = 0.039). Logistic regression identified pre-treatment ICP, CD4 percentage, and tuberculomas as significant risk factors. Linezolid use was a protective factor for ONP recovery.

Conclusions: Six point eight percent (17/250) of patients with TBM developed ONP as a complication. ICP, CD4 counts, and tuberculomas are key predictors. Linezolid shows potential as a therapeutic agent for improving outcomes in TBM patients with neurological complications, warranting further study.

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.