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Inara Contin, Jessica F Ramos, Olavo H Leite, Carlos E Hirata, Joyce H Yamamoto; Epidemiological and clinical characteristics of presumed ocular tuberculosis: a 12-year experience in a tertiary center in Brazil. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2844.
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To describe the epidemiological and clinical characteristics of patients with presumed ocular tuberculosis followed at a tertiary center in Brazil.
Charts of patients notified as presumed ocular tuberculosis (OT) during a 12-year period (1997-2008) at Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP) were retrospectively analysed. Presumed OT was based on the exclusion of other diagnosis, ocular manifestations, tuberculin skin test (TST) > 10mm and positive response to antituberculosis treatment (ATT). No recurrence during one year follow-up after treatment completion defined a positive response and characterized the positive ATT group.
During the 12-year period 4,670 new cases of tuberculosis were compulsory notified at HCFMUSP. Among those patients notified as presumed OT, 44 patients (0.9%) were included for this analysis. Patients were treated for a minimum period of 6 months; 36 patients (81.8%) were treated for one year. Positive ATT (no recurrence during one-year follow-up after treatment) was observed in 22 patients (50%). Evident tuberculosis previous contact were observed in 13 patients (59.1%) in the positive ATT group and in 5 patients (22.8%) in the negative ATT group (p=0.06). TST was ≥ 20mm in 30 patients (68.2%) and there was no difference between both groups. Ocular manifestations observed were uveitis (33 patients, 75%), vasculitis (5 patients, 11.4%), scleritis (4 patients, 9.1%), keratitis and neuritis (1 patient each, 2.2%). Uveitis were anterior, intermediary, posterior or diffuse in respectively 27%, 15%, 27% and 30% of patients. Ocular manifestations did not differ between ATT positive and negative groups.
In this study there were no clear differences between positive and negative ATT groups, except for a history of tuberculosis contact. Further diagnostic tools are desired to increase the reliability of ocular tuberculosis diagnosis.
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