Management of presumed intraocular tuberculosis: possible role of the polymerase chain reaction.
OBJECTIVE
A highly selective technique of polymerase chain reaction (PCR) was performed for detection of Mycobacterium tuberculosis from aqueous samples of 45 patients to evaluate its role in initiating antituberculosis treatment in patients with presumed intraocular tuberculosis.


METHODS
Forty-five patients were divided into three groups. Group I included 17 patients of presumed intraocular tuberculosis, group II 13 disease controls and group III had 15 normal controls. Patients with positive PCR were offered antituberculosis chemotherapy and followed up for a minimum of 18 months.


RESULTS
Ten patients in group I, 3 in group II and none in group III were positive for Mycobacterium tuberculosis by PCR. Ten patients with positive PCR for Mycobacterium tuberculosis (8 in group I and 2 in group II) were treated with antituberculosis chemotherapy and all showed resolution of inflammation without any recurrence over 18 months of follow-up. Two PCR positive patients treated with steroids alone, however, did not show complete resolution and had recurrent attacks.


CONCLUSIONS
These results suggest that antituberculosis treatment in PCR positive patients leads to resolution of inflammation and elimination of recurrences, most likely by eliminating Mycobacterium tuberculosis from the intraocular tissues.
Gupta
V
V
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Arora
S
S
Gupta
A
A
Ram
J
J
Bambery
P
P
Sehgal
S
S
D000293:Adolescent; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000382:microbiology*; D002648:Child; D017931:DNA Primers / Q000737:chemistry; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
D000904:Antibiotics, Antitubercular; D017931:DNA Primers; D004269:DNA, Bacterial; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin