Ocular tuberculosis manifestations are the same as in immunocompetent patients, and disseminated choroiditis is the most commonly cited manifestation. Not only does their immunocompromised status retard recovery, but drug malabsorption is additionally a common problem in HIV infected individuals, mandating longer therapy. Complications Patients should be followed for side effects of medication. Pyrazinamide is associated with hyperuricemia, but acute gout is not common, and asymptomatic hyperuricemia is not an indication to stop the medication. Streptomycin has been associated with hearing loss.
Experts recommend a baseline audiometry before beginning therapy.
Subretinal neovascularization has also been reported, and responded to retinal photocoagulation in at least two reports. The most common reason sited for treatment failure in pulmonary tuberculosis is nonadherance to the therapeutic regimen. DOT involves the direct monitoring of the patient taking the pills by a health care worker. Current recommendations are that all patients should be treated under DOT because there is no way to predict which patients will not comply with the required six to nine month therapy. There is little data on prognosis of ocular TB, again because of rarity of cases.