TB Research

Regional study on the management and coutcomes of Tuberculous Uveitis

Sayed Alderazi, Onyinye Akpenyi, Guy Hagan, Nazim Nathani

Tuberculosis · 2019-09

Abstract

<b>Background:</b> Managing suspected TB Uveitis remains challenging for TB physicians. We explored management of these cases in Sandwell and West Birmingham hospitals Trust; a tertiary ophthalmology centre in an area with high disease burden. <b>Method:</b> Retrospective analysis of medical notes, from 2013-2018, of individuals who received Anti tuberculous therapy (ATT) for TB uveitis. We looked at: further imaging arranged at TB clinic; its influence on management; total duration of ATT; whether corticosteroid therapy was co-prescribed; and outcome. Stable uveitis was defined as either apparent improvement, stable Intra ocular pressure (IOP) or not required further treatment. This was based on ophthalmic assessments: slit lamp examination of the anterior chamber done 6 months after end of ATT and IOP measurement. <b>Results:</b> Sample=40. 26 were Males. Mean Age 46, SD 13.7. 2 patients were lost to follow up while 2 are awaiting opthalmic review. 36 were included in Fisher exact test. 15 out of 36 (42%) received 6 months of ATT without corticosteroids and showed remission. A noticeable but statistically insignificant finding (p value = 0.118 Fisher exact test). All patients had a chest x-ray. 8/40 (20%) patients had CT thorax. 3 had endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) in which histology confirmed granulomatous inflammation in 3 cases - Mycobacterium Tuberculosis was isolated in 1. In conclusion: Collaboration between physicians and opthalmologists positively influenced outcome of uveitis. 6 months of ATT may be sufficient to control TB uveitis.

MeSH terms

  • Medicine
  • Uveitis
  • Tuberculosis
  • Exact test
  • Bronchoalveolar lavage
  • Retrospective cohort study
  • Ophthalmology
  • Surgery