Tuberculosis: an under-diagnosed aetiological agent in uveitis with an effective treatment

Varma, Devesh; Anand, Seema; Reddy, Aravind; Das, Abhay Kumar; Watson, John; Currie, D C; Sutcliffe, Ian; Backhouse, O

doi:10.1038/sj.eye.6702093

Cited by 84 publications

(63 citation statements)

References 24 publications

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“…The use of oral steroid in the majority of patients is clearly a confounding issue, but the continued absence of inflammation after discontinuing oral steroid reassures us that ATT was effective. This and another recent study 16 indicate that for a UK-resident population, in a high proportion of patients with active uveitis, TB is aetiological and not merely an epiphenomenon. In five patients, anterior uveitis developed after discontinuing ATT.…”

Section: Discussionsupporting

confidence: 55%

Presumed tuberculous uveitis: diagnosis, management, and outcome

Sanghvi

Bell

Woodhead

et al. 2011

Eye

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Purpose To assess the effectiveness of anti-tuberculous treatment in patients with chronic uveitis and either active systemic or latent tuberculosis (TB) in a non-endemic community. Methods Retrospective study of patients with chronic uveitis, non-ocular evidence of latent or active TB and no other identified cause of uveitis who underwent a 6-month course of standard anti-tuberculous chemotherapy. Response to treatment was assessed at 6 and 12 months after initiation of treatment. Results A total of 27 patients were included of whom 59% were female. In all, 19 were Asian, 4 Caucasian, and 4 Black. More than half of patients had a history of contact with another person treated for TB. Inflammation resolved after chemotherapy in 70.3% of patients, 18.5% had a change in the nature of their inflammation and 11.1% had no benefit. Conclusions There were no uveitis features characteristic of TB uveitis and a wide range of manifestations was seen ranging from non-granulomatous anterior uveitis to occlusive retinal vasculitis. TB is not endemic in the United Kingdom, therefore consideration of ethnicity, immigration, and history of TB contact remain important to direct investigations. In a patient with uveitis and latent TB, a full 6-month course of antituberculous chemotherapy is recommended although it may not be curative of the uveitis.

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Section: Discussionsupporting

confidence: 55%

Presumed tuberculous uveitis: diagnosis, management, and outcome

Sanghvi

Bell

Woodhead

et al. 2011

Eye

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“…Intraocular TB has not been separately quantified in surveillance data from the UK Health Protection Agency or the World Health Organization, and there have been very few case series of intraocular TB from UK centres. [4][5][6] We present the clinical manifestations and treatment outcomes of patients with presumed intraocular TB, seen in the Newcastle Uveitis Service over a 10-year period.…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation, treatment, and outcomes in presumed intraocular tuberculosis: experience from Newcastle upon Tyne, UK

Manousaridis

Ong

Stenton

et al. 2013

Eye

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Purpose To report the clinical manifestations and treatment outcomes of patients with presumed intraocular tuberculosis (TB) seen at the Newcastle Uveitis Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK over a 10-year period. Methods Retrospective review of case notes. Results A total of 21 patients were identified. Occlusive retinal vasculitis was the commonest ophthalmological presentation (12 patients). Eight patients (38%) were found to have underlying active systemic TB (four with mediastinal lymphadenopathy, three with pulmonary TB, one with cutaneous TB). Constitutional or respiratory symptoms, elevated inflammatory markers, and an abnormal chest radiograph were poor indicators of active TB. Two patients had inactive intrathoracic TB. Eleven patients had latent TB. Eighteen patients received anti-tuberculous treatment. Final visual acuity was better than or equal to initial visual acuity in 14 out of 16 patients who completed at least 6 months of standard anti-tuberculous treatment. Conclusions Most patients with presumed intraocular TB have latent TB, but a significant minority has hitherto undetected active TB. Our series suggests that either proven or presumed intraocular TB occurs frequently in the absence of constitutional or respiratory symptoms, elevated inflammatory markers, or an abnormal chest radiograph. A minimum of 6 months standard anti-tuberculous treatment provides good visual outcomes in the majority of patients.

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“…O teste tuberculínico pode ser na forma do Mantoux ou teste Heaf e para interpretação do resultado é necessário conhecimento da história de vacinação com BCG, exposição à micobactéria não tuberculosa, e estado imunológico (2,6) .…”

Section: Discussionunclassified

“…A uveíte anterior é tipicamente granulomatosa (2) , como nos casos 1 e 2, e no segmento posterior, pode apresentar coroidite focal, coroidite multifocal, granuloma coroidiano e vasculite retiniana (2,8) .…”

Section: Discussionunclassified

“…Nos casos de tuberculose sistêmica, a apresentação ocular ocorre entre 1 a 2% (1) . Manifesta-se como doença primária, quando o olho é foco inicial da infecção, ou secundária, quando o acometimento ocular se dá por via hematogênica (2) . É importante causa de uveíte, de apresentação clínica variada, como iridociclite crônica, coroidite focal ou multifocal, periflebite e ou pan-uveíte (3)(4) .…”

Section: Introductionunclassified

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Tuberculose ocular

Querido¹,

Garcia²,

Rodrigues³

et al. 2008

Rev. bras.oftalmol.

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RESUMORelato de quatro casos de tuberculose ocular presumida, com comprometimento do segmento posterior em três destes casos. Nos dois primeiros casos, relata-se comprometimento do segmento anterior do olho e antecedente de tuberculose, em um caso sistêmica e no outro ocular. No terceiro caso, paciente apresenta lesão coriorretiniana no olho esquerdo. No quarto caso, descrita lesão serpiginosa-like. Os pacientes evoluí-ram favoravelmente com o tratamento específico. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.Descritores: Tuberculose ocular/diagnóstico; Uveíte; Coroidite; Antibióticos antituberculose; Relatos de casos [Tipo de publicação]

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Tuberculosis: an under-diagnosed aetiological agent in uveitis with an effective treatment

Abstract: A high index of suspicion helps diagnose ocular tuberculosis in areas of low prevalence of the disease. It forms part of the differential diagnosis of any chronic or recurrent uveitis, especially in an at-risk patient. Antitubercular treatment seems highly effective.

Cited by 84 publications

References 24 publications

Presumed tuberculous uveitis: diagnosis, management, and outcome

Presumed tuberculous uveitis: diagnosis, management, and outcome

Clinical presentation, treatment, and outcomes in presumed intraocular tuberculosis: experience from Newcastle upon Tyne, UK

Tuberculose ocular

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