Ocular manifestations of tuberculosis: an update

Gupta, Bhaskar; Agrawal, Rupesh; Swampillai, Andrew J.; Lim, Rachel; Kee, Aera; Gunasekaran, Dinesh V.; Pavésio, Carlos

doi:10.1586/17469899.2016.1152887

Cited by 10 publications

(11 citation statements)

References 80 publications

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“…Gupta et al described the distribution of uveal involvement in patients with a presumptive diagnosis of tubercular uveitis (TBU). 5 Out of 182 participants, 70 (39%) had posterior uveitis, 53 (29%) had anterior uveitis, 29 (16%) had intermediate uveitis, and 30 (16%) had panuveitis.…”

Section: Introductionmentioning

confidence: 96%

The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis

Agrawal

Betzler

Testi

et al. 2020

Ocular Immunology and Inflammation

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Purpose:The Collaborative Ocular Tuberculosis Study (COTS) Group sought to address the diagnostic uncertainty through retrospective cohort analysis of treatment regimens and therapeutic outcomes for patients with tubercular Anterior Uveitis (TAU) across international centres.Methods: Multicentre retrospective analysis of patients diagnosed with TAU between January 2004 to December 2014 that had a minimum follow-up of 1 year.Results: One hundred and sixty-five patients were included. One hundred and seven subjects received antitubercular therapy (ATT) (n = 107/165; 64.9%) with all the patients receiving topical steroid therapy. Treatment failure was noted in 17 patients (n = 17/165; 10.3%), more frequently described in patients that received ATT (n = 13/107, 12.2%), than those that did not receive ATT (n = 4/58, 6.9%). Conclusion:In this retrospective study, addition of ATT did not have any statistically significant impact on outcome in patients with TAU.

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Section: Introductionmentioning

confidence: 96%

The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis

Agrawal

Betzler

Testi

et al. 2020

Ocular Immunology and Inflammation

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“…There can also be direct invasion from surrounding areas like paranasal sinus or cranial cavity. Difficulty in obtaining ocular tissue for biopsy often makes it difficult to establish a conclusive diagnosis by demonstrating tuberculosis bacteria in tissue and hence the diagnosis is frequently presumptive [2] [3]. Delayed hypersensitivity reaction to tuberculosis bacteria without the presence of any infectious agent can lead to ocular disease.…”

Section: Introductionmentioning

confidence: 99%

“…This makes the evaluation of ocular fluid sample less sensitive to any laboratory examinations. There is also lack of uniform diagnostic criteria in addition to the difficulties in confirming the diagnosis with traditional laboratory methods [3]. Hence epidemiological data on the true prevalence of ocular TB is scanty and varied in different parts of the world [4] [5] [6].…”

Section: Introductionmentioning

confidence: 99%

Ocular Manifestations among Systemic Tuberculosis Cases: A Hospital Based Study from Nepal

Bhatta¹,

Thakur²,

Shah³

et al. 2019

JTR

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Aim: To study the frequency of various ocular manifestations in diagnosed cases of active pulmonary and extra pulmonary tuberculosis in two different major hospitals in Nepal. Method: A hospital based, cross sectional descriptive study was conducted in the National Tuberculosis Centre, Bhaktapur and BP Koirala Lions Center for Ophthalmic Studies (BPKLCOS), Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal during a period of 18 months from February 2010 to August 2011. Diagnosed cases of systemic tuberculosis were evaluated by ophthalmologists for any ophthalmic manifestations. Results: There were 585 cases in the study. 399 (68%) were cases of pulmonary tuberculosis and 186 (32%) were that of extra pulmonary tuberculosis. Ocular manifestations were seen in 2.6% (15 patients) of the study population; 1.25% (6 patients) in cases of pulmonary tuberculosis and 5.37% (9 patients) in extra pulmonary tuberculosis cases. Uveitis (40%) followed by papilloedema (33%) were the two most common ocular manifestations. Of the 25 affected eyes of 15 patients, 2 eyes of patients with choroiditis involving the macular area were legally blind. Majority of the affected cases (67%) had bilateral involvement. Conclusion: Ocular manifestations in tuberculosis vary greatly ranging from mild episcleritis to potentially blinding posterior uveitis, clinical acumen being of great importance in timely diagnosis and treatment so that vision threatening complications can be prevented. Ocular manifestations are more common in extra pulmonary tuberculosis cases.

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Section: Introductionmentioning

confidence: 99%

“…Intraocular tuberculosis (IOTB) is a unique extrapulmonary manifestation (Gupta et al, 2016 ) of the disease in TB endemic as well as non-endemic countries (Patel et al, 2013 ; Lee et al, 2016 ). No prospective data are available on the population-based prevalence of IOTB either from the low-endemic or the high-endemic TB regions in the world (Gupta et al, 2016 ). However, among the uveitis clinic population, the prevalence of TB as an etiology of uveitis has varied from 0.5% in the USA, 4% in the People's Republic of China, 6.31% in Italy, 6.9% in Japan, 9.86% in north India, 10.5% in Saudi Arabia, and 11.4% in Iraq where TB is endemic (Shakarchi, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Transcriptional Profile of Mycobacterium tuberculosis in an in vitro Model of Intraocular Tuberculosis

Abhishek

Saikia

Gupta

et al. 2018

Front. Cell. Infect. Microbiol.

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Background: Intraocular tuberculosis (IOTB), an extrapulmonary manifestation of tuberculosis of the eye, has unique and varied clinical presentations with poorly understood pathogenesis. As it is a significant cause of inflammation and visual morbidity, particularly in TB endemic countries, it is essential to study the pathogenesis of IOTB. Clinical and histopathologic studies suggest the presence of Mycobacterium tuberculosis in retinal pigment epithelium (RPE) cells.Methods: A human retinal pigment epithelium (ARPE-19) cell line was infected with a virulent strain of M. tuberculosis (H37Rv). Electron microscopy and colony forming units (CFU) assay were performed to monitor the M. tuberculosis adherence, invasion, and intracellular replication, whereas confocal microscopy was done to study its intracellular fate in the RPE cells. To understand the pathogenesis, the transcriptional profile of M. tuberculosis in ARPE-19 cells was studied by whole genome microarray. Three upregulated M. tuberculosis transcripts were also examined in human IOTB vitreous samples.Results: Scanning electron micrographs of the infected ARPE-19 cells indicated adherence of bacilli, which were further observed to be internalized as monitored by transmission electron microscopy. The CFU assay showed that 22.7 and 8.4% of the initial inoculum of bacilli adhered and invaded the ARPE-19 cells, respectively, with an increase in fold CFU from 1 dpi (0.84) to 5dpi (6.58). The intracellular bacilli were co-localized with lysosomal-associated membrane protein-1 (LAMP-1) and LAMP-2 in ARPE-19 cells. The transcriptome study of intracellular bacilli showed that most of the upregulated transcripts correspond to the genes encoding the proteins involved in the processes such as adherence (e.g., Rv1759c and Rv1026), invasion (e.g., Rv1971 and Rv0169), virulence (e.g., Rv2844 and Rv0775), and intracellular survival (e.g., Rv1884c and Rv2450c) as well as regulators of various metabolic pathways. Two of the upregulated transcripts (Rv1971, Rv1230c) were also present in the vitreous samples of the IOTB patients.Conclusions: M. tuberculosis is phagocytosed by RPE cells and utilizes these cells for intracellular multiplication with the involvement of late endosomal/lysosomal compartments and alters its transcriptional profile plausibly for its intracellular adaptation and survival. The findings of the present study could be important to understanding the molecular pathogenesis of IOTB with a potential role in the development of diagnostics and therapeutics for IOTB.

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Ocular manifestations of tuberculosis: an update

Cited by 10 publications

References 80 publications

The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis

The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis

Ocular Manifestations among Systemic Tuberculosis Cases: A Hospital Based Study from Nepal

Transcriptional Profile of Mycobacterium tuberculosis in an in vitro Model of Intraocular Tuberculosis

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