July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Collaborative Ocular Tuberculosis Study (COTS) Consensus guidelines on initiating antitubercular therapy in presumed tubercular choroiditis
Author Affiliations & Notes
  • Vishali Gupta
    Post Graduate Institute of Medical Education and Research, Chandigarh, India., Chandigarh, India
  • Rupesh Vijay Agrawal
    Tan Tock Seng Hospital, Singapore, Singapore
    Nanyang Technological University, Singapore, Singapore
  • Ilaria Testi
    Department of Ophthalmology, University of Padova, Padova, Italy
  • Sarakshi Mahajan
    Byers Eye Institute, Stanford Medical School, California, United States
  • Dhananjay Raje
    MDS Bioanalytics, India
  • Aniruddha Agarwal
    Post Graduate Institute of Medical Education and Research, Chandigarh, India., Chandigarh, India
  • Dinesh Gunasekeran
    Tan Tock Seng Hospital, Singapore, Singapore
  • John H Kempen
    Massachusetts Eye and Ear Harvard Medical School, Massachusetts, United States
  • Quan Dong Nguyen
    Byers Eye Institute, Stanford Medical School, California, United States
  • Carlos Pavesio
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Vishali Gupta, None; Rupesh Agrawal, None; Ilaria Testi, None; Sarakshi Mahajan, None; Dhananjay Raje, None; Aniruddha Agarwal, None; Dinesh Gunasekeran, None; John Kempen, None; Quan Nguyen, None; Carlos Pavesio, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 860. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Vishali Gupta, Rupesh Vijay Agrawal, Ilaria Testi, Sarakshi Mahajan, Dhananjay Raje, Aniruddha Agarwal, Dinesh Gunasekeran, John H Kempen, Quan Dong Nguyen, Carlos Pavesio; Collaborative Ocular Tuberculosis Study (COTS) Consensus guidelines on initiating antitubercular therapy in presumed tubercular choroiditis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):860.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : The decision to initiate antitubercular therapy (ATT) for presumed tubercular choroiditis (SLC) is controversial. An international, expert-led consensus initiative by the Collaborative ocular tuberculosis study (COTS) group developed systematic, evidence and experience based recommendations for the treatment of presumed tubercular choroiditis.

Methods : The international expert steering sub-committee through COTS group identified clinical scenarios pertinent to intraocular tuberculosis. A systematic review of the literature and assigned Oxford levels of evidence was generated for all the clinical scenarios. Using these smart online questionnaires, guided by background knowledge from published literature, the consensus statements were generated for initiating ATT using a modified Delphi technique in patients manifesting with serpiginous like choroiditis. The median score of 5 with interquartile range (IQR) of 0,1,2 and 3 were considered reaching good, moderate, fair and poor consensus respectively for initiating ATT.

Results : There was a strong consensus amongst the experts to initiate ATT in addition to the standard of care (systemic corticosteroids/ immunosuppressive therapy) in patients both from endemic and non-endemic regions with two immunological and one radiologic test positive (median 5, IQR 0); one immunologic and one radiologic test positive (median 5; IQR 0, 1) or two immunologic tests positive with radiology either not done or negative (median 5; IQR 0, 1).

Conclusions : COTS consensus guidelines were developed based on published literature, expert opinion and practical experience to bridge the gap between clinical needs and medical evidence to support the initiation of ATT in patients with presumed tubercular choroiditis.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×