Tuberculous uveitis in China.
OBJECTIVE
To assess tuberculous uveitis in Chinese patients.


METHODS
The hospital-based observational case series study included patients who attended a third-referral hospital and presented with chronic and recurrent uveitis without primarily detected aetiology. The patients underwent the tuberculin skin test (TST) and/or interferon gamma release test (IGRA). Patients with positive test results received standard antituberculous therapy. Patients who responded to the therapy and did not show recurrence of uveitis in the follow-up period were diagnosed as tuberculous uveitis and formed the study group. The remaining patients were diagnosed as non-tuberculous uveitis and formed the control group. The clinical characteristics were compared between both groups.


RESULTS
The study group with tuberculous uveitis included 46 patients and the non-tuberculous group 38 patients. Multifocal choroiditis [n = 9 (20%) versus n = 1(3%); p = 0.04] and retinal vasculitis [n = 25(54%) versus 8 = (21.1%); p = 0.002] were significantly more common in the study group. Of 25 patients with retinal vasculitis in the study group, 11 patients (44%) additionally showed choroiditis lesions, compared with only one (13%) of eight patients in the control group (p = 0.01). In multivariate regression analysis, multifocal choroiditis [odds ratio (OR): 32.1], choroidal granuloma (OR: 21.4) and retinal vasculitis (OR: 11.2) were independent predictors of tubercular uveitis.


CONCLUSIONS
About 50% of a group of 84 patients with primarily unexplained chronic posterior uveitis had tuberculosis and showed multifocal choroiditis, choroidal granuloma and retinal vasculitis. These features had a high predictive value for the diagnosis of tuberculous uveitis. Tuberculosis is an important part in the differential diagnosis of unexplained uveitis.
Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Yu
Y
Mao
Xiao Yan
XY
Peng
Qi Sheng
QS
You
Hong
H
Wang
Meng
M
Zhao
Jost B
JB
Jonas
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D002833:Choroiditis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D000080364:Multifocal Choroiditis; D015995:Prevalence; D031300:Retinal Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015866:Uveitis, Posterior / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents
choroidal granuloma; retinal vasculitis; tuberculosis; tuberculous uveitis; uveitis