Usefulness of T-Spot TB in the First-Line Check-Up of Uveitis Patients

Abstract

Purpose: : Diagnosis of tuberculosis uveitis remains often presumptive, based on epidemiological data, extraocular lesions of tuberculosis, and a positive response to antituberculosis treatment. The main objective of this 1.5 year prospective study of non immunocompromised patients was to evaluate the value of T-SPOT^®.TB as compared to the tuberculin skin test (TST) for the first-line assessment of acute or chronic uveitis.

Methods: : 108 patients underwent a general examination, TST and T-SPOT.TB test (Oxford Immunotec; Oxford, UK) the same day, followed by further blood and serological tests and chest imaging

Results: : Most patients had an inflammation of the posterior segment (84.3%). This classification showed that 66.6% of the patients had either negative (40.7%) or positive tests (25.9%). A presumed or proved tuberculosis was diagnosed in 37.5% of positive T-SPOT.TB cases and 24% of positive TST cases. The results of TST and T-SPOT.TB differed significantly (p=0.001) and were of low concordance (Κ=0.362, p=0.001). BK contact, vaccination and older age were independently associated with T-SPOT.TB positivity. Considering the diagnosis of presumed intraocular tuberculosis, the sensitivities and specificities of TST and T-SPOT.TB were respectively 92.3% and 49.4%, 92.3% and 79%

Conclusions: : In the BCG-vaccinated population, the higher specificity of T-SPOT.TBT will allow avoiding unnecessary complementary investigations and unjustified antituberculosis treatment. T-SPOT^®.TB is useful to guide the management of non immunocompromised patients with uveitis

Keywords: uveitis-clinical/animal model