QuantiFERON-TB Gold Cut-off Value: Implications for the Management of Tuberculosis-Related Ocular Inflammation

Gineys, R.; Bodaghi, Bahram; Carcelain, G.; Cassoux, Nathalie; Boutin, Louis; Amoura, Zahir; LeHoang, Phuc; Trad, S.

doi:10.1016/j.ajo.2011.02.006

Cited by 87 publications

(68 citation statements)

References 21 publications

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“…[15][16][17][18][19] The presentation of granulomatous inflammation in HIV/AIDS patients in study are in accordance to several other studies which were mainly choroidal granulomas and tubercles. [20][21][22][23][24][25][26][27] Our findings that ocular TB in HIV/ AIDS patients all have systemic manifestation are in accordance to Babu et al study that found in HIV/ AIDS patients, all ocular TB patients have pulmonary TB, and among them two cases have coexistent central nervous system TB and one case had abdominal TB.…”

Section: Discussionsupporting

confidence: 78%

Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status

et al. 2012

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Section: Discussionsupporting

confidence: 78%

Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status

et al. 2012

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“…In such a situation the patient should be considered to have ocular tuberculosis until proven otherwise and specific treatment is warranted [3,4,13,14]. However, it is not well known that IGRA tests are in fact not only identifying M. tuberculosis complex but also at least five NTMs including M. kansasii, M. szulgai, M. marinum, M. gordonae and M. flavescens that can cause ocular infections [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…It is commonly accepted that the combination of a positive IGRA test and a compatible clinical picture indicates ocular tuberculosis until proven otherwise and specific therapy should be applied [3,4,13,14].…”

Section: Introductionmentioning

confidence: 99%

Uveitis with occult choroiditis due to Mycobacterium kansasii: limitations of interferon-gamma release assay (IGRA) tests (case report and mini-review on ocular non-tuberculous mycobacteria and IGRA cross-reactivity)

2012

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Ocular tuberculosis is difficult to diagnose but should be suspected when uveitis fails to respond to inflammation suppressive therapy. Interferon-gamma release assays (IGRAs) represent a substantial help to diagnose suspected ocular tuberculosis especially in non-endemic areas. Indocyanine green angiography (ICGA) is able to detect clinically silent choroiditis that, when associated with a positive IGRA test, should lead the clinician to suspect ocular tuberculosis, warranting specific therapy. The fact that IGRA tests can also react with some atypical strains of mycobacteria is not always known. We report here a case with resistant post-operative inflammation that presented with occult ICGA-detected choroiditis and a positive IGRA test that was most probably due to the nontuberculous mycobacterium (NTM) Mycobacterium kansasii. A 66 year-old man presented with a resistant cystoid macular oedema (CMO) in his left eye after combined cataract and epiretinal membrane surgery. At entry, his best-corrected visual acuity (BCVA) was 0.5 for far and near OS. Intraocular inflammation measured by laser flare photometry was elevated in the left eye (54.4 ph/ms) and also in the right eye (50.9 ph/ms). Four subTenon's injections of 40 mg of triamcinolone did not produce any substantial improvement. Therefore a complete uveitis work-up was performed. Fluorescein angiography showed CMO OS and ICGA showed numerous hypofluorescent dots and fuzziness of choroidal vessels in both eyes. Among performed laboratory tests, the Quanti-FERON Ò -TB Gold test was positive. After a pulmonological examination disclosing a right upper lobe infiltrate, the patient was started on a triple antituberculous therapy. Bronchial aspirate, obtained during bronchoscopy, was Ziehl-positive and culture grew M. kansasii. Nine months later, BCVA OS increased to 1.0 and flare decreased to 40.2 ph/ms. The CMO OS resolved angiographically and did not recur with a macula still slightly thickened on OCT. Suspected ocular tuberculosis based on clinical findings and a positive IGRA test can, in rare instances, be due to atypical mycobacteria that also produce positive IGRA tests such as M. kansasii, M. szulgai, M. gordonae, M. flavescens and M. marinum. In our case failure to 123Int Ophthalmol (2012) 32:499-506 DOI 10.1007 isolate the atypical mycobacterium would not have had negative therapeutic consequences, as M. kansasii is sensitive to the standard anti-tuberculous treatments, which is not the case with other NTMs.

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“…Although some studies have recommended a longer duration of 9-18 months of therapy, 3,16 others have followed a 6-month ATT schedule. 17 We followed the WHO recommendations for extra-pulmonary TB. 8 Though a longer duration of 9-12 months is recommended for meningeal TB, there is no evidence to suggest that the same should be followed for ocular TB as well.…”

Section: Site Of Progressive Inflammationmentioning

confidence: 99%

Progressive ocular inflammation following anti-tubercular therapy for presumed ocular tuberculosis in a high-endemic setting

Basu

Nayak

Padhi

et al. 2013

Eye

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QuantiFERON-TB Gold Cut-off Value: Implications for the Management of Tuberculosis-Related Ocular Inflammation

Cited by 87 publications

References 21 publications

Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status

Clinical characteristic and therapy results of presumed ocular tuberculosis and their relation to HIV status

Uveitis with occult choroiditis due to Mycobacterium kansasii: limitations of interferon-gamma release assay (IGRA) tests (case report and mini-review on ocular non-tuberculous mycobacteria and IGRA cross-reactivity)

Progressive ocular inflammation following anti-tubercular therapy for presumed ocular tuberculosis in a high-endemic setting

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