title: Presumed tuberculous uveitis in non-endemic country for tuberculosis: case series from a New Zealand tertiary uveitis clinic.
abstract: BACKGROUND
  To describe the clinical spectrum of presumed tuberculous (TB) uveitis in a developed, non-endemic country of high immigrant population.
  
  
  METHODS
  Retrospective review of a consecutive case series.
  
  
  METHODS
  All 39 patients diagnosed with presumed TB uveitis at the tertiary uveitis service in Auckland from 2007 to 2014.
  
  
  METHODS
  Clinical chart review.
  
  
  METHODS
  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.
authors.affiliation: Ophthalmology Department, Greenlane Clinical Centre, Auckland, New Zealand.
authors.forename: Ken K
authors.initials: KK
authors.lastname: Ng
authors.affiliation: Infectious Disease Department, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Mitzi
authors.initials: M
authors.lastname: Nisbet
authors.affiliation: Ophthalmology Department, Greenlane Clinical Centre, Auckland, New Zealand.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Damato
authors.affiliation: Ophthalmology Department, Greenlane Clinical Centre, Auckland, New Zealand.
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Sims
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis / Q000453:epidemiology*; D014605:Uveitis / Q000175:diagnosis / Q000453:epidemiology*; D014792:Visual Acuity; D055815:Young Adult
keywords: infection; inflammation; tuberculosis; uveitis