title: Long-term close follow-up of chorioretinal lesions in presumed ocular tuberculosis.
abstract: OBJECTIVE
  To evaluate the long-term outcome (up to 7 years) of presumed ocular tuberculosis (TB) when the therapeutic decision was based on WHO guidelines.
  
  
  METHODS
  Twelve out of 654 new uveitic patients (1998-2004) presented with choroiditis and positive tuberculosis skin test (TST) (skin lesion diameter >15 mm). Therapy was administered according to WHO recommendations after ophthalmic and systemic investigation. The area size of ocular lesions at presentation and after therapy, measured on fluorescein and indocyanine green angiographies, was considered the primary outcome. Relapse of choroiditis was considered a secondary outcome. The T-SPOT TB test was performed when it became available.
  
  
  RESULTS
  Visual acuity significantly improved after therapy (p=0.0357). The mean total surface of fluorescein lesions at entry was 44.8 ± 20.9 (arbitrary units) and decreased to 32.5 ± 16.9 after therapy (p=0.0165). The mean total surface of indocyanine green lesions at entry was 24.5 ± 13.3 and decreased to 10.8 ± 5.4 after therapy (p=0.0631). The T-SPOT TB revealed 2 false TST-positive results. The mean follow-up was 4.5 ± 1.5 years. Two relapses out of 10 confirmed ocular TB was observed after complete lesion healing, 2.5 years and 4.5 years after therapy, respectively.
  
  
  CONCLUSIONS
  A decrease of ocular lesion mean size and a mean improvement of VA were observed after antituberculous therapy. Our long-term follow-up of chorioretinal lesions demonstrated relapse of ocular tuberculosis in 10% of patients with confirmed ocular TB, despite complete initial retinal scarring.
authors.affiliation: Jules Gonin Eye Hospital, Lausanne, Switzerland.
authors.forename: Mai-Anh
authors.initials: MA
authors.lastname: Ducommun
authors.forename: Simone
authors.initials: S
authors.lastname: Eperon
authors.forename: Mona B
authors.initials: MB
authors.lastname: Khonkarly
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Yan
authors.initials: Y
authors.lastname: Guex-Crosier
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002833:Choroiditis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D004396:Coloring Agents; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D059425:Interferon-gamma Release Tests; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011718:Pyrazinamide / Q000627:therapeutic use; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004396:Coloring Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007208:Indocyanine Green; D007538:Isoniazid; D012293:Rifampin