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Published on: December 17, 2021
Polymerase Chain Reaction and its Correlation with Clinical Features and Treatment Response in Tubercular Uveitis
Bhagya Sudheer1, Prajna Lalitha2, Arya Lalan Kumar2
1a Department of Uveitis , Aravind Eye Hospital , Madurai , India.
Insights
Polymerase chain reaction for Mycobacterium tuberculosis (MTB PCR) reliably aids in diagnosing tubercular uveitis, showing an 80% correlation with treatment response. A positive MTB PCR result is a strong indicator for intraocular tuberculosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Tubercular uveitis poses diagnostic challenges, often requiring a combination of clinical suspicion and laboratory confirmation.
- Intraocular tuberculosis (TB) diagnosis relies on integrating clinical presentation, imaging, and microbiological tests.
Purpose of the Study:
- To evaluate the correlation between Mycobacterium tuberculosis polymerase chain reaction (MTB PCR) results and clinical features in patients with uveitis.
- To assess the utility of MTB PCR in predicting treatment response to antitubercular therapy (ATT) for uveitis.
Main Methods:
- A retrospective case study design was employed.
- Data from 56 patients diagnosed with uveitis were analyzed.
- MTB PCR results were correlated with clinical presentation, uveitis subtypes, and response to ATT.
Main Results:
- MTB PCR was positive in 24 out of 56 patients (42.8%).
- An 80% correlation was observed between positive MTB PCR results and a good clinical response to ATT.
- The sensitivity of MTB PCR was 73.3%, and specificity was 92.3% for diagnosing tubercular uveitis.
Conclusions:
- A positive MTB PCR result is a reliable indicator in diagnosing intraocular TB.
- Negative MTB PCR results necessitate correlation with clinical features and other diagnostic evidence.
- A favorable response to ATT supports the diagnostic value of MTB PCR in suspected cases of tubercular uveitis.
Purpose:
Correlation of results of polymerase chain reaction for Mycobacterium tuberculosis (MTB PCR) with clinical features and treatment response in tubercular uveitis.
Methods:
Retrospective case study.
Results:
Among 56 patients, 31 (55.3%) had acute and 25 (44.6%) had chronic uveitis. Uveitis was unilateral in 40 (71.4%) and bilateral in the remaining 16 (28.6%). Anatomical subtypes of uveitis were: anterior in 10 (13.9%) eyes, intermediate in 9 (12.5%), posterior in 17 (23.6%), and pan uveitis in 36 (50%) eyes. MTB PCR was positive in 24 patients. There was an 80% correlation between clinical response to antitubercular therapy (ATT) and PCR results. Twenty-two patients with positive PCR had a good clinical response. The sensitivity and specificity was 73.3% and 92.3%, respectively.
Conclusions:
The diagnosis of intraocular TB requires strong clinical suspicion with corroborative laboratory and radiological evidence. A positive PCR is reliable whereas negative results should be correlated with clinical features. An adequate response to ATT supports PCR results.
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