Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study
<i>Background and</i><i>Objectives</i>: This 10-year multicenter retrospective study reviewed the clinical manifestations, diagnostic tests, and treatment modalities of tubercular uveitis (TBU), including direct infection and indirect immune-mediated hypersensitivity to mycob...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/3/376 |
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| author | Chun-Ju Lin Ning-Yi Hsia De-Kuang Hwang Yih-Shiou Hwang Yo-Chen Chang Yueh-Chang Lee Yung-Ray Hsu Po-Ting Yeh Chang-Ping Lin Hsi-Fu Chen Wei-Chun Jan Wei-Yu Chiang Ming-Ling Tsai |
| author_facet | Chun-Ju Lin Ning-Yi Hsia De-Kuang Hwang Yih-Shiou Hwang Yo-Chen Chang Yueh-Chang Lee Yung-Ray Hsu Po-Ting Yeh Chang-Ping Lin Hsi-Fu Chen Wei-Chun Jan Wei-Yu Chiang Ming-Ling Tsai |
| author_sort | Chun-Ju Lin |
| collection | DOAJ |
| description | <i>Background and</i><i>Objectives</i>: This 10-year multicenter retrospective study reviewed the clinical manifestations, diagnostic tests, and treatment modalities of tubercular uveitis (TBU), including direct infection and indirect immune-mediated hypersensitivity to mycobacterial antigens in Taiwan. <i>Materials and Methods</i>: This retrospective chart review of patients with TBU was conducted at 11 centers from 1 January 2008 to 31 December 2017. We used a multiple regression model to analyze which factors influenced best-corrected visual acuity (BCVA) improvement. <i>Results</i>: A total of 79 eyes from 51 patients were included in the study. The mean age was 48.9 ± 16.4 years. The mean change of LogMAR BCVA at last visit was −0.21 ± 0.45. Diagnostic tools used include chest X-ray, chest computed tomography, Mantoux test, interferon gamma release test (QuantiFERON-TB Gold test), intraocular fluid tuberculosis polymerase chain reaction, and bronchial alveolar lavage. The clinical manifestations included 48% posterior uveitis and 37% panuveitis. In the sample, 55% of the cases were bilateral and 45% unilateral. There was 60.76% retinal vasculitis, 35.44% choroiditis, 21.52% serpiginous-like choroiditis, 17.72% vitreous hemorrhage, 12.66% posterior synechiae, 6.33% retinal detachment, and 3.80% choroidal granuloma. Treatment modalities included rifampicin, isoniazid, pyrazinamide, ethambutol, oral steroid, posterior triamcinolone, non-steroidal anti-inflammatory drugs, vitrectomy, and immunosuppressants. BCVA improved in 53.2% of eyes and remained stable in 32.9% of eyes. In the final model of multiple regression, worse initial BCVA, pyrazinamide, and receiving vitrectomy predicted better BCVA improvement. Ethambutol was associated with worse visual outcomes. Seven eyes experienced recurrence. <i>Conclusions</i>: This is the largest 10-year multicenter retrospective study of TBU in Taiwan to date, demonstrating the distribution of clinical manifestations and clinical associations with better treatment outcomes. The study provides a comprehensive description of TBU phenotypes in Taiwan and highlights considerations for the design of further prospective studies to reliably assess the role of ATT and vitrectomy in patients with TBU. |
| first_indexed | 2024-03-09T13:24:07Z |
| format | Article |
| id | doaj.art-35455ce6639e4a2ea6430c4a9592d074 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T13:24:07Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-35455ce6639e4a2ea6430c4a9592d0742023-11-30T21:26:06ZengMDPI AGMedicina1010-660X1648-91442022-03-0158337610.3390/medicina58030376Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective StudyChun-Ju Lin0Ning-Yi Hsia1De-Kuang Hwang2Yih-Shiou Hwang3Yo-Chen Chang4Yueh-Chang Lee5Yung-Ray Hsu6Po-Ting Yeh7Chang-Ping Lin8Hsi-Fu Chen9Wei-Chun Jan10Wei-Yu Chiang11Ming-Ling Tsai12Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, TaiwanDepartment of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404, TaiwanDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei 112, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Linkou 333, TaiwanDepartment of Ophthalmology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 807, TaiwanDepartment of Ophthalmology, Hualien Tzu Chi Hospital, Hualien 970, TaiwanDepartment of Ophthalmology, Far Eastern Memorial Hospital, New Taipei 220, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Ophthalmology, Mackay Memorial Hospital, Hsinchu 300, TaiwanDepartment of Ophthalmology, Mackay Memorial Hospital, Taipei 104, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDepartment of Ophthalmology, Taipei Tzu Chi Hospital, Tri-Service General Hospital, Taipei 231, Taiwan<i>Background and</i><i>Objectives</i>: This 10-year multicenter retrospective study reviewed the clinical manifestations, diagnostic tests, and treatment modalities of tubercular uveitis (TBU), including direct infection and indirect immune-mediated hypersensitivity to mycobacterial antigens in Taiwan. <i>Materials and Methods</i>: This retrospective chart review of patients with TBU was conducted at 11 centers from 1 January 2008 to 31 December 2017. We used a multiple regression model to analyze which factors influenced best-corrected visual acuity (BCVA) improvement. <i>Results</i>: A total of 79 eyes from 51 patients were included in the study. The mean age was 48.9 ± 16.4 years. The mean change of LogMAR BCVA at last visit was −0.21 ± 0.45. Diagnostic tools used include chest X-ray, chest computed tomography, Mantoux test, interferon gamma release test (QuantiFERON-TB Gold test), intraocular fluid tuberculosis polymerase chain reaction, and bronchial alveolar lavage. The clinical manifestations included 48% posterior uveitis and 37% panuveitis. In the sample, 55% of the cases were bilateral and 45% unilateral. There was 60.76% retinal vasculitis, 35.44% choroiditis, 21.52% serpiginous-like choroiditis, 17.72% vitreous hemorrhage, 12.66% posterior synechiae, 6.33% retinal detachment, and 3.80% choroidal granuloma. Treatment modalities included rifampicin, isoniazid, pyrazinamide, ethambutol, oral steroid, posterior triamcinolone, non-steroidal anti-inflammatory drugs, vitrectomy, and immunosuppressants. BCVA improved in 53.2% of eyes and remained stable in 32.9% of eyes. In the final model of multiple regression, worse initial BCVA, pyrazinamide, and receiving vitrectomy predicted better BCVA improvement. Ethambutol was associated with worse visual outcomes. Seven eyes experienced recurrence. <i>Conclusions</i>: This is the largest 10-year multicenter retrospective study of TBU in Taiwan to date, demonstrating the distribution of clinical manifestations and clinical associations with better treatment outcomes. The study provides a comprehensive description of TBU phenotypes in Taiwan and highlights considerations for the design of further prospective studies to reliably assess the role of ATT and vitrectomy in patients with TBU.https://www.mdpi.com/1648-9144/58/3/376antitubercular therapyethambutolnon-steroidal anti-inflammatory drugspyrazinamidetubercular uveitisvitrectomy |
| spellingShingle | Chun-Ju Lin Ning-Yi Hsia De-Kuang Hwang Yih-Shiou Hwang Yo-Chen Chang Yueh-Chang Lee Yung-Ray Hsu Po-Ting Yeh Chang-Ping Lin Hsi-Fu Chen Wei-Chun Jan Wei-Yu Chiang Ming-Ling Tsai Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study Medicina antitubercular therapy ethambutol non-steroidal anti-inflammatory drugs pyrazinamide tubercular uveitis vitrectomy |
| title | Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
| title_full | Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
| title_fullStr | Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
| title_full_unstemmed | Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
| title_short | Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
| title_sort | clinical manifestations and outcomes of tubercular uveitis in taiwan a ten year multicenter retrospective study |
| topic | antitubercular therapy ethambutol non-steroidal anti-inflammatory drugs pyrazinamide tubercular uveitis vitrectomy |
| url | https://www.mdpi.com/1648-9144/58/3/376 |
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