Tuberculous Uveitis

Uveitis is predominantly of infectious origin in a high HIV and TB prevalence setting in rural South Africa

“…In addition to herpes viruses, M. tuberculosis was a common cause of uveitis in our study confirming previous reports from other TB endemic settings that show an increasing aetiological role of M. tuberculosis in uveitis 17. Indeed, TB uveitis was also the most common cause of infectious uveitis in India 18.…”

Controversies in ocular tuberculosis

“…On the other hand, some studies report OTB as a percentage of all uveitis cases, which may range from 7% to 10.5% 8. Cross-sectional studies estimate a range from 1% to 4% areas with low TB endemicity, such as the USA, Europe and Japan, to 10%–26% in highly endemic regions such as India and Saudi Arabia 9. Even the reports of OTB prevalence within a country vary according to region, from <1% in tertiary referral clinics to 10% or more in highly endemic regions of North America 2.…”

Treatment of severe non-infectious uveitis in high-risk conditions (Part 2): systemic infections; management and safety issues

“…Regardless, it seems necessary to properly identify these patients not only to prevent the development of active disease under certain favoring circumstances as aforementioned, but also to prevent the spread of the disease to other individuals. Once active TB has been excluded (Table 4 [131]), a diagnosis of LTBI is based on two essential components [131]: Tuberculin skin test (TST) and IFN-g release assays (IGRAs) ( Table 5) [131,[134][135][136][137][138][139][140][141][142]. The agreement between these tests is elevated and both are included in clinical guidelines of many scientific societies, although recommendations regarding their use are controversial [143].…”

“…Regarding medical history, it is crucial to rule out certain risk factors such as previous contact with TB patients, drug abuse, HIV infection, high-endemic region origin and working with people at risk or in crowded conditions [78]. With respect to complementary tests, both Agence française de s ecurit e sanitaire des produits de sant e and CDC consider TST and IGRAs as equivalent in the screening of TST IGRAs progression to TB disease* --Children younger than 5 years of age --Infants, children and adolescents exposed to adults in highrisk categories* Data taken from [131,[134][135][136][137][138][139][140][141][142]. *HIV infection, injection-based drug use, radiographic evidence of prior healed TB, low body weight (10% below ideal), other medical conditions (such as silicosis, diabetes mellitus, chronic renal failure or on hemodialysis, gastrectomy, jejunoileal bypass, solid organ transplant, head and neck cancer, conditions that require prolonged use of corticosteroids or other immunosuppressive agents such as TNF-a antagonists), recent TST converters (i.e., persons with baseline testing results who have an increase of 10 mm or more in the size of the TST reaction within a 2-year period), infants LTBI [140,168,175].…”