Lack of consensus in the diagnosis and treatment for ocular tuberculosis among uveitis specialists

Ocul Immunol Inflamm. 2015 Feb;23(1):25-31. doi: 10.3109/09273948.2014.926936. Epub 2014 Jul 14.

Abstract

Purpose: To assess the approach of specialists to ocular tuberculosis (TB).

Methods: The American Uveitis Society (AUS) Listserv was surveyed using two clinical cases and general questions.

Results: Of 196 members, 87 responded (44.4%), of whom 64 were affiliated with practices in North America, while 23 were outside of North America. The survey provided normative data on how physicians evaluate patients with uveitis as well as opinions about ocular TB. Responses varied widely on such issues as (1) the pretest probability that a patient with granulomatous panuveitis had TB uveitis (range 1-75%) or that a patient with a risk factor for TB had ocular TB (range 0-90%); (2) the optimal duration of anti-TB therapy; and (3) whether therapy should be discontinued after 2 months in nonresponders.

Conclusions: Consensus is lacking among uveitis specialists for the diagnosis or management of ocular TB.

Keywords: Post-test probability; pretest probability; tuberculosis; uveitis.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Consensus*
  • Diagnosis, Differential
  • Humans
  • Societies, Medical*
  • Tuberculin Test
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / microbiology
  • United States
  • Uveitis / diagnosis*
  • Uveitis / drug therapy
  • Uveitis / microbiology

Substances

  • Antitubercular Agents