Newer trends in tubercular uveitis: a case series with systemic correlation

Area of Science:

• Ophthalmology
• Infectious Diseases
• Immunology

Background:

• Systemic tuberculosis (TB) can manifest with ocular involvement, leading to significant visual impairment.
• Uveitis is a common ocular manifestation of TB, with varied clinical presentations and potential for vision loss.

Purpose of the Study:

• To investigate the spectrum of uveitis in systemic TB.
• To identify causes of visual loss in these patients.
• To evaluate the role of diagnostic investigations and the outcomes of anti-TB therapy (ATT).

Main Methods:

• Retrospective study of 250 patients with systemic TB.
• Systemic workup including Mantoux, chest X-ray, PCR, and QuantiFERON (QFT) TB Gold.
• Ocular investigations included aqueous humor analysis (nested PCR/RT-PCR) and ancillary ophthalmic tests.

Main Results:

• Multifocal choroiditis (39%) and vasculitis (24%) were the most common uveitis types.
• Pulmonary TB (PTB) was associated with uveitis in 18% of cases.
• Aqueous humor analysis was diagnostic in 96% of inconclusive cases.
• Vision improved in 69% of patients, with complete resolution in 75%.

Conclusions:

• Combining clinical suspicion with diagnostic investigations, especially ocular sample analysis, aids precise TB uveitis diagnosis.
• A multidisciplinary approach and screening of all TB patients are recommended.
• Prompt ATT and corticosteroid treatment improve visual outcomes.