Clinical commentaryVisual pathway abnormalities in tuberculous meningitis

- Ophthalmological complications are disabling in patients with tuberculous meningitis (TbM).
- 43 patients with TbM underwent visual evoked response [VER] and neuroophthalmologic assessment.
- Neuroophthalmologic assessment revealed abnormality in 22 (51.3%) while abnormal VER was detected in 27 (62.8%) patients.
- VER can detect early and subclinical changes in the visual pathways in TbM.

Ophthalmological complications are common and disabling in patients with tuberculous meningitis. We aimed to study the visual pathway abnormalities in patients with tuberculous meningitis. Forty-three patients with tuberculous meningitis were subjected to visual evoked responses (VER) and neuroophthalmologic assessment. Neuroophthalmologic assessment revealed abnormalities in 22 (51.3%) patients. VER were found to be abnormal in 27 (62.8%) patients. The VER abnormalities included prolonged P100 latencies with relatively normal amplitude and significant interocular latency differences. Visual pathways abnormalities are common in patients with tuberculous meningitis and are often subclinical. Pathophysiologic explanations for electrophysiological abnormalities on VER in these patients are incompletely understood and needs further exploration.