Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis

Journal Article

, Al-Mezaine HS, Al-Muammar A, Kangave D, Abu El-Asrar AM. . 2008

• المجلة \ الصحيفة: Int Ophthalmol.
• رقم العدد: 6
• رقم الإصدار السنوي: 28
• الصفحات: 413-23

مستخلص المنشور

PurposeTo deÞne the clinical characteristics and optical coherence tomographic (OCT) features, and to assess the outcome of treatment, in patients with presumed tuberculous uveitis (PTU).
Methods All patients diagnosed with PTU at King Abdulaziz University Hospital between January 1998 and May 2006 were reviewed. The diagnosis was made when Þndings were consistent with possible intraocular tuberculosis with no other cause of uveitis suggested by history, symptoms, or ancillary testing, strongly positive tuberculin skin-test results, and response to antituberculous therapy.
Results Fifty-one patients (73 eyes) were identiÞed. There were 34 males (66.7%) and 17 females (33.3%) with a mean age of 40.1 ± 11.0 years (range 16Ð68 years). Fifty-eight eyes (79.5%) had panuveitis and 15 eyes (20.5%) had posterior uveitis at presentation. Clinical manifestations included vitritis (71.2%), macular edema (63%), retinal periphlebitis (35.6%), multifocal choroiditis (20.5%), and granulomatous anterior uveitis (17.9%). All patients received antituberculous therapy and systemic corticosteroids. After a meanfollow-up of18.9± 21.9 months (range 6Ð96 months), all eyes showed resolution of inßammation, with no recurrences, associated with signiÞcant improvement in visual acuity (VA) ( P = 0.007). There was a signiÞcant positive correlation between initial and Þnal VAs (r = 0.7856,P\ 0.001). Thirty-one eyes with macular edema were examined at baseline and at follow-up with OCT. There were three patterns of macular edema: diffuse (DME) (28.5%), cystoid (29%), and serous retinal detachment (45.2%). Initial VA of 20/40 or better was signiÞcantly associated with central macular thickness (CMT) of 300l m or less (P = 0.0065) and DME (0.0484). At Þnal follow-up, there was a signiÞcant reduction in CMT ( P\ 0.001) associated with a signiÞcant improvement in VA (P = 0.0091).
Conclusions Antituberculous therapy combined with systemic corticosteroids leads to resolution of inßammation and elimination of recurrences of PTU. OCT is useful in monitoring the efÞcacy of treatment in patients with macular edema.
Keywords Macular edema Optical coherence tomography Tuberculosis Uveitis