September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Ocular Tuberculosis at AUBMC, a Tertiary Care Center in Lebanon
Author Affiliations & Notes
  • Rola N Hamam
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Huda Sheheitli
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Wajiha Jurdi Kheir
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Maamoun Abdul Fattah
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Footnotes
    Commercial Relationships   Rola Hamam, None; Huda Sheheitli, None; Wajiha Jurdi Kheir, None; Maamoun Abdul Fattah, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1886. doi:
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      Rola N Hamam, Huda Sheheitli, Wajiha Jurdi Kheir, Maamoun Abdul Fattah; Ocular Tuberculosis at AUBMC, a Tertiary Care Center in Lebanon. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1886.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Our aim was to study the characteristics of patients with presumed ocular TB uveitis & assess their long-term outcomes & complications after receiving anti-TB drug therapy. We also aim to evaluate the role of steroids.

Methods : This was a retrospective analysis done on patients diagnosed with presumed tuberculosis uveitis at AUBMC from January 2009–2015. Patients with positive PPD test along with clinically suggestive uveitis unexplained by any other etiology & who have shown response to 4 anti-TB drug therapy for 2-4 weeks were included. Pertinent information collected included visual acuity, intraocular pressure, slit lamp examination findings & anatomic location of intraocular inflammation at presentation, 6 and 18 months of follow-up.

Results : Our study included a total of 35 eyes (21 patients, mean age: 46.9 ± 18.3 years; 10 females). 57.1% (20/35) of which had panuveitis, 40% (14/35) had posterior uveitis & only 1 eye had anterior uveitis. Twenty patients had positive PPD & all of them were started on anti-TB therapy. After 6 months of treatment, 36% of eyes gained 2 or more lines & none of them lost 2 lines. At 18 months, 35% of the eyes gained 2 or more lines & 13% lost 2 or more lines (n=23). There was a significant improvment in visual acuity on LogMar scale at 6 months (0.485±0.7 to 0.297 ±0.576; p=0.012). Also, response to treatment was significant with respect to AC cells, vitreous cells, chorioretinitis, and papillitis at 6 months (p<0.05); however vasculitis improved at later stage of the follow up (18 months; p<0.05). At presentation 51.4% (18/35) of eyes had macular edema which was shown to improve to 27.3% (9/33) at 6 months (p=0.051) and 23.8% (5/21) at 18 months follow up (p=0.053). Using the Chi-square test, there was no statistically significant correlation between visual improvement with the location of the disease, prolonged duration of disease, presence of macular edema and prior steroid/immunosuppressive therapy use. Eyes started on steroids at presentation in addition to anti-TB therapy, did not show any significant improvement with regard to their vision or resolution of macular edema compared to anti TB alone.

Conclusions : Corticosteroid use does not adversely affect the outcome in TB uveitis prior to initiation or after initiation of anti TB treatment. Vasculitis required a longer period of treatment for response.

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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