The Role of Anti-tubercular Therapy in Patients with Presumed Ocular Tuberculosis

Abstract

Objective: To analyze the factors affecting the treatment outcome in patients with presumed ocular tuberculosis on anti-tubercular therapy (ATT).

Methods: Retrospective chart review of patients with presumed ocular tuberculosis seen at a tertiary referral eye care center in the United Kingdom. Failure was defined as recurrence of inflammation within 6 months of completion of ATT.

Results: There were a total of 175 patients with presumed ocular tuberculosis who had ATT. Patients with intermediate uveitis or panuveitis and those on immunosuppressive therapy had higher odds of treatment failure (p < 0.05) while those with more than 9 months of ATT (77, 79.38%) had less likelihood of failure.

Conclusion: We present the largest case series of patients with presumed ocular tuberculosis in a low endemic area treated with ATT. Longer duration of treatment resulted in reduced risk of recurrence of inflammation, whereas immunosuppression adversely affected the final treatment outcome.

• Anti-tubercular therapy (ATT)
• duration of ATT
• immunosuppression
• intermediate uveitis
• presumed ocular tuberculosis
• QuantiFERON gold in tube (QFT)

Declaration of interest

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

JJGL has received study grants from Alcon, Novartis, and Merck, and has provided unpaid consultancy to Bayer. RA is on an NMRC overseas research training fellowship at the Institute of Ophthalmology and Moorfields Eye Hospital, London. This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

The authors would like to acknowledge support from Margaret Richards who helped in identifying case records with QFT at our center.

Author contributions

BG wrote the first draft of the manuscript and was involved in critical input and data analysis and interpretation. RA edited the first draft of the manuscript and was involved in study design, data collection, analysis, and intellectual input. JJGL contributed to the first draft of the manuscript and did statistical analysis. FR, IT, and SP were involved in data collection. CP, PA, and MW were directly involved in patient care and edited the draft and provided intellectual input for the study design and data collection.