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Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study
Background andObjectives: 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. Materials...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950060/ https://www.ncbi.nlm.nih.gov/pubmed/35334552 http://dx.doi.org/10.3390/medicina58030376 |
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author | Lin, Chun-Ju Hsia, Ning-Yi Hwang, De-Kuang Hwang, Yih-Shiou Chang, Yo-Chen Lee, Yueh-Chang Hsu, Yung-Ray Yeh, Po-Ting Lin, Chang-Ping Chen, Hsi-Fu Jan, Wei-Chun Chiang, Wei-Yu Tsai, Ming-Ling |
author_facet | Lin, Chun-Ju Hsia, Ning-Yi Hwang, De-Kuang Hwang, Yih-Shiou Chang, Yo-Chen Lee, Yueh-Chang Hsu, Yung-Ray Yeh, Po-Ting Lin, Chang-Ping Chen, Hsi-Fu Jan, Wei-Chun Chiang, Wei-Yu Tsai, Ming-Ling |
author_sort | Lin, Chun-Ju |
collection | PubMed |
description | Background andObjectives: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. |
format | Online Article Text |
id | pubmed-8950060 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89500602022-03-26 Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study Lin, Chun-Ju Hsia, Ning-Yi Hwang, De-Kuang Hwang, Yih-Shiou Chang, Yo-Chen Lee, Yueh-Chang Hsu, Yung-Ray Yeh, Po-Ting Lin, Chang-Ping Chen, Hsi-Fu Jan, Wei-Chun Chiang, Wei-Yu Tsai, Ming-Ling Medicina (Kaunas) Article Background andObjectives: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. MDPI 2022-03-03 /pmc/articles/PMC8950060/ /pubmed/35334552 http://dx.doi.org/10.3390/medicina58030376 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lin, Chun-Ju Hsia, Ning-Yi Hwang, De-Kuang Hwang, Yih-Shiou Chang, Yo-Chen Lee, Yueh-Chang Hsu, Yung-Ray Yeh, Po-Ting Lin, Chang-Ping Chen, Hsi-Fu Jan, Wei-Chun Chiang, Wei-Yu Tsai, Ming-Ling Clinical Manifestations and Outcomes of Tubercular Uveitis in Taiwan—A Ten-Year Multicenter Retrospective Study |
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 | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950060/ https://www.ncbi.nlm.nih.gov/pubmed/35334552 http://dx.doi.org/10.3390/medicina58030376 |
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