Spectrum of Choroidal Involvement in Presumed Ocular Tuberculosis: Report from a Population with Low Endemic Setting for Tuberculosis

ABSTRACT

Objective: To describe the clinical spectrum and outcome of patients with presumed tubercular uveitis and choroidal involvement.

Methods: A retrospective case series nested in a cohort study was enrolled at a tertiary referral eye care center in the UK. Failure was defined as recurrence of lesion within 6 months of completion of antitubercular therapy (ATT) or corticosteroid therapy.

Results: Seventy-seven patients with presumed ocular tuberculosis and choroidal involvement were included in the study. Mean age was 45.5 ± 15.7 years, 44 (57.1%) patients were male, and 51 (66.2%) presented with bilateral disease. Choroidal granuloma was the most frequent clinical presentation (n = 27, 35.07%), followed by multifocal choroiditis (n = 24, 31.17%) and serpiginous-like choroiditis (n = 18, 23.38%). Quantiferon Gold in Tube Test (QFT) was positive in 64 (83.11%) patients. Fifty (64.94%) patients received ATT.

Conclusions: Choroidal involvement in presumed ocular tuberculosis can present with a variable spectrum. Treatment failure rates were equivalent between ATT and non-ATT treated groups.

Keywords:

• Antitubercular therapy (ATT)
• choroidal granuloma
• duration of ATT
• QuantiFERON GOLD in tube (QFT)
• presumed ocular tuberculosis
• serpiginous-like choroiditis

DECLARATION OF INTEREST

The authors report no conflict of interest. Dr. Rupesh Agrawal has been sponsored for National Medical Research Council (NMRC), Ministry of Health (MOH), Singapore overseas research training fellowship at Institute of Ophthalmology, University College London and Moorfields Eye Hospital, London, United Kingdom. He is currently receiving grant support from Clinician Scientist Career Scheme (CSCS), National Healthcare Group (NHG), Singapore.