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The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Descriptive Review of Tubercular Uveitis in

Ilaria Testi1, Rupesh Agrawal1,2,3,4, Sarakshi Mahajan5

  • 1Moorfields Eye Hospital, NHS Foundation Trust, London, UK.

Ocular Immunology and Inflammation
|August 18, 2020
PubMed

Insights

Pediatric tubercular uveitis (TBU) presents more severely in children, often affecting the posterior segment and optic nerve. Intensive anti-inflammatory treatment is crucial for positive outcomes in pediatric TBU cases.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Infectious Diseases

Background:

  • Tubercular uveitis (TBU) is a significant cause of ocular inflammation.
  • Understanding the disease profile in pediatric populations is crucial for effective management.

Purpose of the Study:

  • To characterize the disease profile of tubercular uveitis (TBU) specifically in pediatric patients.
  • To compare the clinical presentation and outcomes of TBU in children versus adults.

Main Methods:

  • Retrospective analysis of 29 pediatric patients diagnosed with TBU from the Collaborative Ocular Tuberculosis Study (COTS)-1 multinational database.
  • Evaluation of demographic data, uveitis phenotype, ocular involvement (choroidal, optic disc edema, macular edema), and treatment outcomes.

Main Results:

  • The mean age of presentation was 12.8 years, with a male predominance (70%) and predominantly Asian ethnicity (86.2%).
  • Posterior uveitis (50%) was the most common phenotype, with high rates of choroidal involvement (64.7%).
  • Pediatric patients showed a higher incidence of optic disc edema (44.4%) and macular edema (27.8%) compared to adults, with a significant difference in optic disc edema (P=.006).

Conclusions:

  • Children exhibit a more severe inflammatory response to tubercular uveitis.
  • An intensive anti-inflammatory therapeutic regimen, often combined with antitubercular therapy, is necessary for successful treatment outcomes in pediatric TBU.

Keywords:
Collaborative Ocular Tuberculosis Study (COTS)Ocular tuberculosischildrenpediatric populationtubercular uveitis

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