Abstract
Purpose :
This prospective study examines the clinical characteristics of tubercular uveitis (TBU), and the treatment outcome with antituberculosis treatment (ATT) and oral corticosteroid and/or immunosuppressive agents (IMT)
Methods :
This observational prospective study was conducted at a tertiary eye care centre in southern India between May 2018 and September 2022. The study was approved by the institutional board of the hospital and adhered to the tenets of the declaration of Helsinki. The diagnosis of TBU was confirmed by suggestive clinical features along with laboratory investigations. All patients underwent a course of 9-month ATT with oral corticosteroid. Additional treatment with immunosuppressives was added if the inflammation did not respond to the oral corticosteroid treatment , if recurrences developed despite oral corticosteroid usage, or if patients experienced side effects due to corticosteroids.
Results :
A total of 120 eyes of 77 patients with TBU were included in the study. The mean age of patients was 36.56 ± 12.34 years and 59.7% were males. Bilateral involvement was seen in 54.5% patients. Intermediate uveitis ( 32.5%), panuveitis ( 28.3%), and posterior uveitis ( 25.8 %) were the most common subtypes of uveitis. Among the laboratory investigations, TST was positive in 58 (75.3%) patients, and a positive IGRA was noted in 55 (71.4%). In 36 patients whose Chest X-rays were normal, HRCT Chest in 25 of them revealed positive radiological findings. All patients received corticosteroids with ATT. Additional, immunosuppressives were used in 23 (29.8%) patients. Ocular complications were encountered in 68 (56.6%) eyes. Eighteen eyes (15%) developed more than one complication. Among patients who developed ocular complications, 75% were treated with ATT and oral steroids without receiving IMT (p = 0.025). The mean BCVA significantly improved from 0.41 ± 0.64 log units at the initial visit to 0.21 ± 0.47 log units after an average follow-up of 661.09 days. At the final follow-up, BCVA remained <6/60 in ten eyes of eight patients. All eight patients were treated with oral steroids and ATT but did not receive immunosuppressives.
Conclusions :
This is the first-ever prospective analysis providing the clinical profile and treatment outcomes of TBU, emphasizing the importance of IMT alongside ATT and corticosteroid
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.