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Presumed tuberculous uveitis in non‐endemic country for tuberculosis: case series from a New Zealand tertiary uveitis clinic
Author(s) -
Ng Ken K,
Nisbet Mitzi,
Damato Erika M,
Sims Joanne L
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12881
Subject(s) - medicine , uveitis , retinal vasculitis , interquartile range , tuberculosis , intermediate uveitis , visual acuity , retrospective cohort study , cohort , ophthalmology , pediatrics , surgery , vasculitis , anterior uveitis , disease , pathology
A bstract Background To describe the clinical spectrum of presumed tuberculous (TB) uveitis in a developed, non‐endemic country of high immigrant population. Design Retrospective review of a consecutive case series. Participants All 39 patients diagnosed with presumed TB uveitis at the tertiary uveitis service in Auckland from 2007 to 2014. Methods Clinical chart review. Main Outcome Measures Patient demographics, risk factors, ophthalmic manifestations, management and outcome. Results The median age was 37 years (interquartile range [IQR] 31–52) and 56% were female. The majority (97%) were born outside of New Zealand, and 77% had no TB‐related history. Radiological abnormalities consistent with TB were evident in seven patients, including three who had culture positive pulmonary disease. Anterior uveitis was diagnosed in ten patients (26%), anterior and intermediate uveitis in eight (21%), posterior uveitis in 13 (33%) and panuveitis in eight (21%). Sixteen (41%) had retinal vasculitis, and five (13%) had multifocal serpiginoid choroiditis. Common complications included cataract (51%), ocular hypertension (36%), broad posterior synechiae (33%) and cystoid macular oedema (28%). Anti‐TB treatment was initiated in 30 patients (76%). All but three patients completed the intended course of six to 12 months. Following anti‐TB treatment, 67% remained in remission for at least 12 months, and all but two patients successfully stopped systemic steroids. The median initial and final visual acuity was 6/9 (IQR 6/6–6/18) and 6/6 (IQR 6/6–6/9), respectively. Conclusions Despite a wide range of ocular presentations and complications, our cohort demonstrated good remission rate and visual prognosis following anti‐TB treatment in carefully selected patients.