Optical coherence tomography biomarkers and visual functions in tuberculous meningitis: an observational study.

Purpose: To evaluate changes in optical coherence tomography (OCT) parameters and visual function in Tuberculous Meningitis (TBM) patients during a short-term follow-up period. A prospective case-control observational study was performed at a Medical University from August 2020 to July 2021.

Method: A study was conducted at a medical institute in Northern India, including 52 patients with TBM who presented within one month of systemic symptoms. Optical Coherence Tomography parameters, retinal nerve fiber layer (RNFL) thickness, central sub-foveal thickness (CST), cube average thickness (CAT), and visual function were evaluated at the time of presentation and after one month of follow-up period.

Results: The study included 52 TBM patients, the mean age was 27 (51.9%) and 25 (48.1%) years, out of 52 patients, 24 (46.2%) were male, and 28 (53.8%) were female. OCT revealed significant thickening of the RNFL, mean of 108.7 μm in the right eye and 108.69 μm in the left eye after 1 month of diagnosis. No significant difference was found between macular parameters (CST, CAT) and visual functions.

Conclusions: OCT biomarkers, particularly RNFL thickness, are significantly altered in TBM patients, indicating its potential as a sensitive marker for monitoring retinal changes. The macula appears to be spared in the early phase of TBM, and visual acuity remains relatively unaffected in the short-term follow-up.