Twenty-four Month Outcomes in the Collaborative Ocular Tuberculosis Study (COTS)-1: Defining the “Cure” in Ocular Tuberculosis

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ABSTRACT

Purpose: To report the clinical findings, anatomical features, and treatment outcomes in subjects with ocular tuberculosis (OTB) at 24 months in the Collaborative Ocular Tuberculosis Study (COTS)-1.

Methods: Of the 945 subjects included in COTS-1, those who completed a 24-month follow-up after completion of treatment were included. The main outcome measure was a number of patients with treatment failure (TF).

Results: 228 subjects (120 males; mean age of 42.82 ± 14.73 years) were included. Most common phenotype of uveitis was posterior (n = 81; 35.53%), and panuveitis (n = 76; 33.33%). Fifty-two patients (22.81%) had TF. On univariable analysis, odds of high TF was observed with bilaterality (OR: 3.46, p = .003), vitreous haze (OR: 2.14, p = .018), and use of immunosuppressive therapies (OR: 5.45, p = .003). However, only bilaterality was significant in the multiple regression model (OR: 2.84; p = .02).

Conclusions: Majority of subjects (>75%) achieved cure in the COTS-1 at 24-month follow-up. The concept of “cure” may be a valuable clinical endpoint in trials for OTB.

KEYWORDS:

• Ocular tuberculosis
• uveitis
• antitubercular therapy
• tuberculous
• tubercular uveitis
• cure
• Collaborative Ocular Tuberculosis Study (COTS) group

Declaration of interest

All authors do not have any conflicts of interest to declare.

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 the Department of Biotechnology (DBT), India. Julio J GONZÁLEZ-LÓPEZ2 is supported by study grants from AbbVie, Allergan, and Angelini. Funders played no part in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; nor the decision to submit the manuscript for publication.