Abstract
Purpose: :
to evaluate an Enzyme-Linked Immunospot (ELISPOT)-Interferon gamma assay and tuberculin skin test (TST) in detecting latent Mycobacterium tuberculosis infection in patients with uveitis.
Methods: :
a total of 43 patients with uveitis followed at the Ocular Immunology Service of the San Raffaele University Hospital-Milan, underwent the Mantoux TST and ELISPOT-IFN-gamma assay. All diagnostic tests were performed in the laboratory of the Infectious Disease Department of the San Raffaele Hospital. Ocular diagnosis were grouped in: serpiginous choroiditis (9 pts), posterior uveitis (10 pts), panuveitis (14 pts) and anterior segment inflammatory diseases (uveitis and scleritis) (10 pts). Patients characteristics evaluated included: demographic data (age, gender, race), ocular data (laterality, visual acuity).
Results: :
43 caucasian patients (20 Female, 23 Male), with a median age of 53 years (range 9-85) were evaluated. Ocular involvement was bilateral in 76% of patients. The median visual acuity at the time of testing was 0,7 (range: 0.02-1.0). The rate of positivity in the whole population was: 73% for TST and 58% for ELISPOT. In different subset of diagnosis TST and ELISPOT positivity were respectively: 89% and 78% in the serpiginous choroiditis group; 80% and 70% in the posterior uveitis group; 57% and 43% in the panuveitis group; 80% and 45% in the anterior segment inflammation group.
Conclusions: :
ELISPOT has shown to be more accurate than TST in identifying subjects with latent TB infection. This diagnostic test could improve detection of uveitis of tuberculous etiology.
Keywords: microbial pathogenesis: clinical studies • clinical laboratory testing • bacterial disease