Infectious uveitis: an Asian perspective

Agarwal, Aniruddha; Aggarwal, Kanika; Gupta, Vishali

doi:10.1038/s41433-018-0224-y

Cited by 27 publications

(12 citation statements)

References 132 publications

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“…The majority of patients were born in Pakistan, India, or Africa, representing 11, 7, and 7 cases, respectively. It is well recognised that TB is endemic in Asian countries with India accounting for 20% of the global TB burden [ 19 ]. This finding highlights the importance of establishing country of birth in patients presenting with uveitis as this is a major risk factor for TB and should prompt further investigation.…”

Section: Discussionmentioning

confidence: 99%

Presumed ocular tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study

Shirley

Dowlut

Silvestri

et al. 2020

Eye

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Introduction Ocular tuberculosis (TB) is an extrapulmonary manifestation of mycobacterium infection that most commonly presents as uveitis. This is the first prospective incidence study of presumed ocular tuberculosis performed in the United Kingdom (UK). Method New cases of ocular tuberculosis presenting to hospitals in the UK were prospectively ascertained between October 2016 and November 2017 with the aid of the British Ophthalmological Surveillance Unit (BOSU). Initial presentation data and 1-year follow-up data was collected using questionnaires. Results Forty-eight patients were recruited giving an overall incidence for ocular TB of 0.73 per million population per annum. The origin of birth for 71% of the patients was a non-UK country and 87.5% had their initial diagnosis of TB made by an ophthalmologist. The most common first line treatment was isoniazid, rifampicin, ethambutol and pyrazinamide which 71% of patients were treated with 60% of patients were commenced on a reducing course of oral steroids. At 1-year follow-up, 29 patients (83%) had complete resolution of active clinical signs. Mean best corrected visual acuity (BCVA) at presentation was +0.41 LogMAR(SD = 0.62), compared to +0.31 LogMAR (SD = 0.56) at 12-month follow-up. Discussion It is increasingly the responsibility of the ophthalmologist to diagnose ocular TB and although it remains a rare condition, consensus on diagnostic criteria and treatment is required. Increasing recognition and accessibility to gamma-interferon testing should enable earlier detection. Treatment with quadruple ATT treatment regimens for at least 6 months shows good clinical outcomes. However, it is still unclear whether steroid use is beneficial. Further large studies with longer follow-up would be warranted to answer these questions.

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Section: Discussionmentioning

confidence: 99%

Presumed ocular tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study

Shirley

Dowlut

Silvestri

et al. 2020

Eye

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“…Using these devices, it is also possible to obtain montage of FAF images. [22][23][24][25] In addition, ultra-wide field imaging may be superior to conventional imaging in identifying changes such as peripheral paradoxical worsening (worsening of the primary disease upon initiation of anti-TB therapy due to possible release of antigens from the mycobacteria; Ocular Jarisch-Herxheimer reaction) which may be otherwise missed on conventional imaging. Aggarwal et al examined 44 eyes with TB SLC using UWF imaging in detection of paradoxical worsening.…”

Section: Ultrawide-field and Montage Photographymentioning

confidence: 99%

Imaging in Tubercular Choroiditis: Current Concepts

Agarwal

Invernizzi

Markan

et al. 2020

Ocular Immunology and Inflammation

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Purpose: Ocular tuberculosis has protean clinical manifestations. Because of its varied clinical presentation, multimodal imaging is essential to characterize the disease activity, presence of inflammation, determining therapeutic response, and detection of complications. Methods: Narrative reviewResults: In this review, various imaging modalities employed in the management of ocular tuberculosis including fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) have been reviewed. Not only do these imaging tools complement each other in providing a comprehensive assessment of the pathology, they also help in gaining valuable insights regarding the evolution of the disease.Conclusions: Fundus imaging plays a vital role in the diagnosis and management of patients with posterior uveitis due to tuberculosis. Fundus imaging may have a useful role in defining clinical endpoints for ocular tuberculosis in the future.

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“…Dengue fever, an arthropod-borne disease, caused by four serotypes of Dengue virus, can manifest various ophthalmologic symptoms, such as subconjunctival hemorrhage, keratitis, anterior uveitis, angle-closure glaucoma as for anterior segment and, more commonly, ME, retinal hemorrhages, foveolitis, cotton wool spots, AMN lesions, and microaneurysms as for posterior segment involvement [98]. Deduced from case reports, OCTA has proven to be a worthy diagnostic tool for detecting flow deficits in the perifoveal region within the DCP and SCP in ischemic inflammatory foveolitis and outer maculopathy, even when fundus lesions were not detectable [98–100].…”

Section: About the Implementation Of Optical Coherence Tomography Angmentioning

confidence: 99%

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Dingerkus

Munk

Brinkmann

et al. 2019

J Ophthal Inflamm Infect

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Background The broad spectrum of uveitis disorders requires a multimodal imaging approach in the daily practice of an ophthalmologist. As inflammatory conditions, they have in common an alteration in leukocyte migration. In this context, optical coherence tomography angiography (OCTA) might be of great value for diagnosing or following up patients with these disorders. To date, OCTA has rather been used as an additional tool besides the well-established diagnostic imaging tools, but its complementary diagnostic features become increasingly relevant, to follow disease activity and treatment response and for the understanding of pathomechanisms of various uveitis types. This review summarizes the possible applications of OCTA and its advantages and disadvantages as opposed to dye-based angiographies in uveitic diseases. Main body Hitherto gold standards in the diagnostic workup of posterior or intermediate uveitis have been angiography on a dye-based method, which is fluorescein or indocyanine green. It gives information about the status of the blood-retinal barrier and the retinal and choroidal vasculature by visualizing diffuse leakage as a state of inflammation or complications as an ischemia or choroidal neovascularization. As noninvasive methods, fundus autofluorescence depicts the status of metabolic activity of the retinal pigment epithelium and OCT or enhanced depth imaging OCT, respectively, as a depth-resolving imaging method can supply additional information. OCTA as a non-invasive, depth-resolution imaging tool of retinal and choroidal vessels adds detailed qualitative and quantitative information of the status of retinal and choroidal vessels and bridges the gap between the mentioned conventional diagnostic tools used in uveitis. It is important, though, to be aware of its limitations, such as its susceptibility to motion artifacts, limited comparability among different devices, and restricted contribution of information regarding the grade of disease activity. Conclusion OCTA as a non-invasive, depth-resolution imaging tool can give qualitative and quantitative information about the status of retinal and choroidal vessels, but also has certain limitations. Employing OCTA as a complementary rather than exclusive tool, it can give important additional information about the macro- and microvasculature under inflammatory circumstances. Thereby, it also contributes to the understanding of the pathophysiology of various uveitis entities.

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Infectious uveitis: an Asian perspective

Cited by 27 publications

References 132 publications

Presumed ocular tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study

Presumed ocular tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study

Imaging in Tubercular Choroiditis: Current Concepts

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

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