The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Description of the Spectrum of Choroidal Involvement in 245 Patients with Tubercular Uveitis

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ABSTRACT

Purpose: To contribute a global description of the spectrum of choroidal involvement in tubercular uveitis (TBU).

Methods: Retrospective cohort study of TBU patients with choroidal involvement from 25 centers between January 2004 and December 2014. Medical records of patients with a minimum follow-up of 1 year were reviewed.

Results: 245 patients were included. The phenotypic variations included serpiginous-like choroiditis (SLC) (46%), tuberculoma (13.5%), multifocal choroiditis (MFC) (9.4%), ampiginous choroiditis (9%), among others. 219 patients were treated with anti-tubercular therapy (ATT) (n = 219/245, 89.38%), 229 patients with steroids (n = 229/245, 93.47%) and 28 patients with immunosuppressive agents (n = 28/245, 11.42%). Treatment failure was noted in 38 patients (n = 38/245, 15.5%). Patients with SLC and ampiginous choroiditis appeared to have superior outcomes on survival analysis (p = 0.06).

Conclusion: This study provides a comprehensive description of choroidal involvement in TBU. Patients with SLC and ampiginous choroiditis may have better clinical outcomes.

Keywords:

• Anti-tubercular therapy
• choroiditis
• ocular
• tuberculosis
• uveitis

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The research was partially funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. This sponsor supported some of the research man-hours that were contributed by all our part-time collaborators from the Moorfields Eye Hospital that are salaried as Ophthalmology clinicians by the hospital. Debra A. Goldstein is supported by an unrestricted grant from Research to Prevent Blindness (RPB). Vishali Gupta is supported by grant from Department of Biotechnology (DBT), India. Julio J Gonalez-Lopez is supported by study grants from AbbVie, Allergan, and Angelini.