Clinical Significance of T-SPOT.TB Test in Patients With Uveitis in South Korea.

PURPOSE: To investigate the clinical significance of T-SPOT.TB results in patients with uveitis in South Korea, an intermediate tuberculosis (TB) burden country, and to compare clinical characteristics and treatment patterns by T-SPOT.TB results.

DESIGN: Retrospective clinical cohort study.

METHODS: This study included 382 patients diagnosed with uveitis who underwent both T-SPOT.TB test with interpretable results and chest imaging at a tertiary referral center between 2013 and 2022. Clinical data, including the anatomical location of uveitis and treatment regimens, were compared between T-SPOT.TB-positive and negative groups. Additional analyses compared pulmonology referrals, antitubercular therapy administration, and chest imaging and microbiologic findings.

RESULTS: Among 382 patients, 125 (32.7%) were T-SPOT.TB-positive. The T-SPOT.TB-positive group had a higher mean age (55.9 vs 42.5 years, P < .001) and a higher prevalence of prior TB history (5.6% vs 0.8%, P = .007). No significant differences were found in the anatomical distribution of uveitis (P = .073) or treatment patterns, including corticosteroid monotherapy and use of immunomodulatory agents or biologics (P = .175 and P = .238, respectively). Of the T-SPOT.TB-positive patients, 54 (43.2%), were referred to the pulmonology department, and 14 received treatment for latent TB infection, and 1 patient, later diagnosed with TB lymphadenitis, underwent full antitubercular therapy. No patients demonstrated active pulmonary TB.

CONCLUSIONS: In this real-world cohort from a TB intermediate-burden country, T-SPOT.TB positivity was not associated with clinical features or treatment burden of uveitis. The findings suggest that T-SPOT.TB positivity in uveitis patients may reflect background latent infection rather than active ocular involvement.