Duration of anti-tubercular therapy in uveitis associated with latent tuberculosis: a case-control study

To study the effect of the duration of anti-tubercular treatment (ATT) on the recurrence of uveitis associated with latent tuberculosis (TB).

Retrospective review of all consecutive uveitis patients seen at a single, tertiary institution over 9 years with uveitis consistent with TB, positive tuberculin skin test with other causes ruled out, and a minimum of 6 months follow-up after completion of treatment. Clinical characteristics, treatment type, treatment duration and clinical response were recorded. Our main outcome measure was the effect of ATT duration on the recurrence of inflammation.

Of the 182 eligible patients, 46 received ATT of ≥ 6 month's duration; 18 patients defaulted and received < 6 months treatment. The patients' mean age was 45.3 ± 13.2 years and most were female (n=118, 57.6%) and of Chinese race (n=104, 50.7%). Patients who completed > 9 months ATT were less likely to develop recurrence compared with those not treated with ATT (OR 0.09; 95% CI 0.01 to 0.76; p=0.027), while adjusting for potential confounders such as patient demographics, anatomical location of uveitis and corticosteroid therapy.

Patients with uveitis and latent TB treated with ATT of > 9 months duration had an 11-fold reduction in the likelihood of recurrence.