Clinical signs of uveitis associated with latent tuberculosis.
BACKGROUND
To identify the clinical ocular signs of uveitis associated with latent tuberculosis.


METHODS
Retrospective case-control study.


METHODS
Consecutive patients from Singapore National Eye Centre Uveitis over 9 years. Sixty-two patients with uveitis associated with latent tuberculosis were compared with 72 matched controls diagnosed with other known uveitides.


METHODS
Patients were categorized as: (A) predominantly anterior segment inflammation (anterior uveitides) and (B) predominantly posterior segment inflammation (intermediate, posterior or pan-uveitides). The diagnostic performance of combining these clinical signs with investigations such as interferon-gamma release assay positivity and chest X-ray results suggestive of pulmonary tuberculosis was done using area under the receiver operator characteristic curve.


METHODS
Sensitivity, specificity and likelihood of association with tuberculosis of various clinical signs.


RESULTS
Extensive posterior synechiae and concomitant anterior scleritis in Group A; low-grade anterior chamber activity, retinal phlebitis and severe vitritis in Group B were significantly associated with latent tuberculosis. Combining these clinical signs with a positive interferon-gamma release assay and tuberculin skin test improved the diagnostic performance in both groups (area under the receiver operator characteristic curve for Group A = 0.779; Group B = 0.789).


CONCLUSIONS
Patients with a combination of suggestive clinical signs with positive interferon-gamma release assay and tuberculin skin test are more likely to be accurately diagnosed with uveitis associated with latent tuberculosis, which responds to anti-tuberculosis therapy.
Singapore National Eye Centre, National University Health Systems, Singapore.
Marcus
M
Ang
Alireza
A
Hedayatfar
Rongli
R
Zhang
Soon-Phaik
SP
Chee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D019540:Area Under Curve; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
D000995:Antitubercular Agents