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Miguel Naveiras, Karen Arriozola, Dagoberto Almanzar, Eva Villota-Deleu, Alvaro Fernandez Vega, Jesus Merayo-Lloves; Presumed Ocular Tuberculosis In Patients With Chronic Uveitis And Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3210.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the prevalence and treatment outcome of presumed ocular tuberculosis at a tertiary specialized center in Northern Spain.
Retrospective, nonrandomized, comparative interventional study. 48 consecutive patients newly referred to Instituto Oftalmológico Fernández-Vega from February to October 2011, with idiopathic chronic uveitis and macular edema, were included in the study. Diagnosis of presumed ocular tuberculosis was made with a combination of consistent clinical findings, positive QuantiFERON-TB Gold In-Tube (QFT) and lack of other identifiable causes by ancillary tests and uveitis questionnare. Patients were treated with a regime of antituberculosis drugs, steroids and immunosupressants. Reduction in intraocular inflammation, extra ocular involvement and adverse effects were studied. Best spectacle corrected visual acuity (BSCVA) and macular thickness by OCT was measured at peak inflammation and after 6 months of treatment.
39.6% of chronic uveitis with macular edema were diagnosed with presumed intraocular tuberculosis. Uveitis was considered controlled with treatment in 94.7% (p<0.05). Extra ocular TBC involvement was found in 26.3%. Adverse effects to antituberculosis drugs occurred in 15.8%. Mean peak BSCVA was 0.7, final 0.76 (p=0.273) Mean peak macular thickness was 311±94.67 microns, final 280±112.23 (p=0.128)
Chronic uveitis with macular edema was found to be to be highly realted to presumed ocular tuberculosis. Treatment with standard antituberculosis protocol and appropriate management of inflammation can preserve visual function, control macular edema and prevent sight-threatening complications for at least six months.
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