Six-Month Versus Nine-Month Anti-Tubercular Therapy for Tubercular Posterior Uveitis: A Multicenter, Randomized
Talluri Ronnie Abhishek1,2, Md Hasnat Ali3, May Zun Aung Win4
1Uveitis Service, LV Prasad Eye Institute, Kode Venkatadri Chowdary Campus, Vijayawada, India.
Seminars in Ophthalmology
|December 9, 2025
Summary
Six-month anti-tubercular therapy (ATT) is as effective as 9-month ATT in preventing recurrent ocular inflammation. This finding supports shorter treatment durations for ocular tuberculosis (TB).
Area of Science:
- Ophthalmology
- Infectious Diseases
- Clinical Trials
Background:
- Ocular tuberculosis (TB) requires anti-tubercular therapy (ATT).
- The optimal duration of ATT for ocular TB is not well-established.
- Recurrent intraocular inflammation is a significant concern in ocular TB management.
Purpose of the Study:
- To compare the efficacy of 6-month ATT versus 9-month ATT in preventing recurrent intraocular inflammation in patients with ocular TB.
- To assess the non-inferiority of a shorter ATT duration.
Main Methods:
- A multi-center, open-label, non-inferiority randomized controlled trial was conducted.
- Patients aged 18 years or older with tubercular posterior uveitis were randomized to receive either 6- or 9-month ATT.
- The primary outcome was the non-recurrence of inflammation one year after completing ATT.
Main Results:
- Both 6-month and 9-month ATT regimens demonstrated high non-recurrence rates.
- The 6-month ATT regimen was found to be non-inferior to the 9-month regimen.
- Subgroup analysis suggested potential differences in efficacy between phenotypes, favoring 6-month ATT for retinal vasculitis and 9-month ATT for serpiginous-like choroiditis (SLC).
Conclusions:
- Six-month ATT is non-inferior to 9-month ATT for treating tubercular posterior uveitis.
- Shorter ATT durations may be considered, with potential adjustments based on clinical phenotypes.
- No drug toxicity-related discontinuations were reported in either treatment group.
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