The Collaborative Ocular Tuberculosis Study (COTS)-1 Report 3: Polymerase Chain Reaction in the Diagnosis and Management of Tubercular Uveitis: Global Trends

ABSTRACT

Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis.

Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included.

Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation.

Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.

Keywords:

• Anti-tubercular therapy
• choroidal tuberculoma
• choroiditis
• polymerase chain reaction
• tuberculosis

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, 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.Rupesh Agrawal, Dinesh Visva Gunasekeran, Robert Grant, and Dhananjay Raje had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.