Visual Morbidity in Ocular Tuberculosis – Collaborative Ocular Tuberculosis Study (COTS)-1: Report #6

Abstract

Objective: Aim of the study was to examine extent, natural history and clinical features associated with visual impairment (VI) in patients diagnosed with ocular tuberculosis (OTB) by the Collaborative Ocular Tuberculosis Study (COTS)-1.Methods: Multi-center retrospective cohort study. Main outcomes were VI.Results: A total of 302 patients were included in the study, including 175 patients whose data related to BCVA were available throughout the 2 years of follow up. Mean BCVA grossly improved at 12, 18 and 24 months of follow-up (p<0.001). Mean BCVA was worse at 12-18th month follow-up for patients treated with ATT versus patients who were not treated with ATT, but patients treated with ATT had a statistically significant improvement in BCVA at the 24-month endpoint.Conclusions: OTB is associated with significant visual morbidity, future well designed prospective studies are warranted to establish the causal association between OTB and visual loss.

Clinics of ocular tuberculosis: A review

“…Based on clinical phenotype, this was 9.6% in TAU, 2.8% in TIU, 6.0% in TPU, and 5.6% in TBP 83 . During follow up, mean best‐corrected visual acuity improved in the first 3 months and subsequently remained stable, with further improvement at 12, 18 and 24 months 83 . The authors subsequently emphasized managing patients' expectations for rapid visual recovery and the importance of long‐term ATT compliance, given that the beneficial impact of ATT may take 18 to 24 months to be noticed.…”

“…As for visual acuity, severe visual impairment and blindness (WHO category 3) were noted in 5.6% of patients at baseline, and in 5.9% at follow up 42 . A recent multinational analysis on visual morbidity by COTS reported a 11.4% incidence of severe visual impairment/ blindness (WHO category 3) 83 . Based on clinical phenotype, this was 9.6% in TAU, 2.8% in TIU, 6.0% in TPU, and 5.6% in TBP 83 .…”

“…A recent multinational analysis on visual morbidity by COTS reported a 11.4% incidence of severe visual impairment/ blindness (WHO category 3) 83 . Based on clinical phenotype, this was 9.6% in TAU, 2.8% in TIU, 6.0% in TPU, and 5.6% in TBP 83 . During follow up, mean best‐corrected visual acuity improved in the first 3 months and subsequently remained stable, with further improvement at 12, 18 and 24 months 83 .…”

“… Agrawal et al 83 reported follow up at 12, 18 and 24 months post therapy cessation. Listed here are the values at 24 months follow up.…”

Retinal Microvascular Alterations in Patients with Quiescent Posterior and Panuveitis Using Optical Coherence Tomography Angiography

“…3,4 The frequency of visual loss (20/60 or worse) with posterior uveitis can be as high as 50%. 3,[5][6][7][8] Among patients with panuveitis, the frequency of visual loss is even 60%. 3,5,6 Patients with posterior or panuveitis can develop complications such as (chronic) macular edema, epiretinal membrane, vasculitis, papillitis, retinal artery or vein occlusions, retinal necrosis, tractional retinal detachment, choroidal or retinal neovascularization, vitreous hemorrhage, glaucoma and cataract leading to further visual loss.…”