Management of presumed intraocular tuberculosis, possible role of the polymerase chain reaction

Gupta, Vishali; Arora, Sunil; Gupta, Amod; Ram, Jagat; Bambery, P.; Sehgal, S

doi:10.1034/j.1600-0420.1998.760609.x

Cited by 89 publications

(49 citation statements)

References 12 publications

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“…PCR testing has provided encouraging although unvalidated results for both intraocular 18,19 and other extrapulmonary 20 TB. Such tests are not routinely recommended for TB diagnosis in the United Kingdom 5 because of poor predictive value, especially falsenegative results.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

Presumed tuberculous uveitis: diagnosis, management, and outcome

Sanghvi

Bell

Woodhead

et al. 2011

Eye

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“…[11][12][13] In one study, MTb-PCR was detected from aqueous specimens in 60% of patients with presumed intraocular TB. 11 PCR testing has yet to be standardized and is not recommended for TB diagnosis in the United Kingdom, because of its poor predictive value due to false negative results. 14 Moreover, the pathophysiology of intraocular TB remains controversial.…”

Section: Discussionmentioning

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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“…The ocular TB cases presenting with iris nodules or iridocyclitis in the literature demonstrated severe anterior uveitis with corneal involvement, responding to anti-TB therapy. [5][6][7] On the contrary, in our case, the anterior chamber reaction was more localized and slight probably owing to the topical steroid treatment.…”

Section: Ocular Tuberculosis Ms Saricaog Lu Et Al 220mentioning

confidence: 40%