September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Impact of antitubercular therapy in patients with presumed intraocular tuberculosis at a tertiary referral eye care centre in Singapore
Author Affiliations & Notes
  • Leslie Jonathan Ang
    National Healthcare Group Eye Institute, Singapore, Singapore
  • Aera Kee
    National University of Singapore, Singapore, Singapore
  • Tun Hang Yeo
    National Healthcare Group Eye Institute, Singapore, Singapore
  • Dinesh Gunasekeran
    Tan Tock Seng Hospital, Singapore, Singapore
  • SU LING HO
    National Healthcare Group Eye Institute, Singapore, Singapore
  • STEPHEN TEOH
    Eagle Eye Centre, Singapore, Singapore
  • Rupesh Vijay Agrawal
    National Healthcare Group Eye Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Leslie Ang, None; Aera Kee, None; Tun Yeo, None; Dinesh Gunasekeran, None; SU LING HO, None; STEPHEN TEOH, None; Rupesh Agrawal, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1889. doi:
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      Leslie Jonathan Ang, Aera Kee, Tun Hang Yeo, Dinesh Gunasekeran, SU LING HO, STEPHEN TEOH, Rupesh Vijay Agrawal; Impact of antitubercular therapy in patients with presumed intraocular tuberculosis at a tertiary referral eye care centre in Singapore. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1889.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Tuberculous uveitis is a diagnostic and therapeutic conundrum. We report the demographics, clinical features of patients with presumed tuberculosis-related uveitis (TBU) in Singapore, and aim to analyse the treatment outcome of patients on anti-tubercular therapy (ATT) and corticosteroid therapy, as well as determine the factors predictive of treatment failure.

Methods : We performed a retrospective analysis of patients with presumed TBU at a tertiary referral eye care centre in Singapore between 2007 and 2012. All patients had a minimum follow-up of 12 months, and our main outcome measure was a failure of complete resolution of the uveitis or recurrence of inflammation at 12 and 24 months post commencement of treatment.

Results : Fifty-three patients were included with a mean age of 44.18 ± 15.26 years and 54.72% were males. Nineteen (35.85%) patients had bilateral involvement with panuveitis and anterior uveitis being the most common presentations. Thirty-six (67.92%) patients received ATT of which 8 received concurrent ATT and systemic steroids. Of the 17 (32.08%) patients that did not receive ATT, 5 received systemic steroids in addition to their topical steroids. Eleven (20.75%) patients in the ATT group and 3 (27.27%) patients in the non-ATT group had treatment failure at 12 months (p = 0.511) while 6 patients had treatment failure at 24 months ( p= ) . The clinical phenotypes of uveitis and having a combination of positive tuberculin skin test, chest radiographic imaging or interferon gamma release assays also had no impact on the treatment outcome.

Conclusions : ATT may not have a statistically significant impact in improving treatment success in patients with presumed TBU. There were no significant predictive factors for treatment failure and chest imaging is recommended as a routine investigation for a uveitic workup. A large-scale, multi-centre, prospective study is advised to devise an appropriate treatment guideline for TBU.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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