Clinical Significance of T-SPOT.TB Test in Patients With Uveitis in South Korea
Jae Shin Song1, Seok Hyeon Song1, Min Seok Kim1
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea (all authors).
Purpose:
To investigate the clinical significance of T-SPOT.TB results in patients with uveitis in South Korea, an intermediate tuberculosis (TB) burden country, and to compare clinical characteristics and treatment patterns by T-SPOT.TB results.
Design:
Retrospective clinical cohort study.
Methods:
This study included 382 patients diagnosed with uveitis who underwent both T-SPOT.TB test with interpretable results and chest imaging at a tertiary referral center between 2013 and 2022. Clinical data, including the anatomical location of uveitis and treatment regimens, were compared between T-SPOT.TB-positive and negative groups. Additional analyses compared pulmonology referrals, antitubercular therapy administration, and chest imaging and microbiologic findings.
Results:
Among 382 patients, 125 (32.7%) were T-SPOT.TB-positive. The T-SPOT.TB-positive group had a higher mean age (55.9 vs 42.5 years, P < .001) and a higher prevalence of prior TB history (5.6% vs 0.8%, P = .007). No significant differences were found in the anatomical distribution of uveitis (P = .073) or treatment patterns, including corticosteroid monotherapy and use of immunomodulatory agents or biologics (P = .175 and P = .238, respectively). Of the T-SPOT.TB-positive patients, 54 (43.2%), were referred to the pulmonology department, and 14 received treatment for latent TB infection, and 1 patient, later diagnosed with TB lymphadenitis, underwent full antitubercular therapy. No patients demonstrated active pulmonary TB.
Conclusions:
In this real-world cohort from a TB intermediate-burden country, T-SPOT.TB positivity was not associated with clinical features or treatment burden of uveitis. The findings suggest that T-SPOT.TB positivity in uveitis patients may reflect background latent infection rather than active ocular involvement.
