Update on Immunological Test (Quantiferon-TB Gold) Contribution in the Management of Tuberculosis-Related Ocular Inflammation

ABSTRACT

Purpose: To clarify interferon-gamma release assay (IGRA) contributions to intraocular tuberculosis management, according to related TB endemic prevalence.

Methods: Despite extensive investigations, including IGRA, the diagnosis of intraocular tuberculosis (TB) is still challenging and remains mostly presumptive. According to the literature, it appears that management of suspected ocular TB differs significantly based on whether patients are from areas of high TB prevalence or from non-TB-endemic countries. The accuracy and final contribution of chest X-rays, tuberculin skin test and IGRA differ significantly according to low or high endemic TB areas. This work aims to review IGRA test outcomes in the light of these clinical and epidemiological settings. We therefore focused our analysis and its subsequent guidelines proposal based on the TB prevalence where the patient lives.

Conclusion: We believe that distinct guidelines should be determined for managing patients with suspected ocular TB, first taking into consideration the relative TB prevalence.

Keywords:

• Guidelines
• IGRA
• ocular tuberculosis
• Quantiferon
• uveitis

This article is referred to by:

Comment on Trad et al.’s “Update on Immunological Test (Quantiferon-TB Gold) Contribution in the Management of Tuberculosis-Related Ocular Inflammation”

Main Point Summary

This work aims to review the contribution and accuracy of chest X-rays, the tuberculin skin test, and IGRAs in the diagnosis of ocular tuberculosis. It highlights significant discrepancies based on epidemiological settings. Our subsequent proposed guidelines are therefore based on the TB prevalence where the patient lives.

Declaration of Interest

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