Ocular TB in Western Australia

SETTING This was a retrospective chart review in Western Australia, Australia. OBJECTIVE To describe the diagnosis, management, and treatment outcomes of ocular TB in Western Australia (WA). DESIGN This was a retrospective review of ocular TB cases in WA from 2007 to 2018 with a minimum 2-year follow-up upon completion of anti-TB therapy (ATT). RESULTS A total of 44 patients were referred to WA TB clinic. Ten were excluded from the analysis of treatment response; 34 met the inclusion criteria, of whom 97.1% were born overseas. No patients had symptomatic extraocular TB. Chest X-ray showed prior pulmonary TB in 11.7% of patients ( n = 4). All patients were treated with three or four ATT drugs. The most common ocular TB manifestation was retinal vasculitis (23.5%). Full resolution of ocular inflammation following ATT occurred in 66.7% ( n = 22), and reduced ocular inflammation requiring only topical steroid treatment was seen in 21.2% ( n = 7). Treatment failure occurred in 12.1% ( n = 4). Side effects were reported in 45.6% of patients, with gastrointestinal symptoms most common (27.2%). CONCLUSION Our study is the first Australian study examining the management of ocular TB. Our study highlights the challenges in diagnosing TB ocular disease in a low-endemicity setting and the importance of the collaboration between uveitis and TB subspecialists. .