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

Ocul Immunol Inflamm. 2017 Feb;25(1):97-104. doi: 10.3109/09273948.2015.1087577. Epub 2016 Jan 25.

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); QuantiFERON GOLD in tube (QFT); choroidal granuloma; duration of ATT; presumed ocular tuberculosis; serpiginous-like choroiditis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Choroiditis / diagnosis
  • Choroiditis / drug therapy
  • Choroiditis / epidemiology*
  • Drug Therapy, Combination
  • Endemic Diseases / statistics & numerical data*
  • Female
  • Glucocorticoids / therapeutic use
  • Granuloma / diagnosis
  • Granuloma / drug therapy
  • Granuloma / epidemiology*
  • Humans
  • Interferon-gamma Release Tests
  • London / epidemiology
  • Male
  • Middle Aged
  • Multifocal Choroiditis
  • Retrospective Studies
  • Tuberculin Test
  • Tuberculosis, Ocular / diagnosis
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / epidemiology*
  • Young Adult

Substances

  • Antitubercular Agents
  • Glucocorticoids

Supplementary concepts

  • Multifocal choroiditis