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Erschienen in: Infection 4/2018

04.06.2018 | Original Paper

Early treatment of tuberculous uveitis improves visual outcome: a 10-year cohort study

verfasst von: Luis Anibarro, Eliana Cortés, Ana Chouza, Alberto Parafita-Fernández, Juan Carlos García, Alberto Pena, Carlos Fernández-Cid, África González-Fernández

Erschienen in: Infection | Ausgabe 4/2018

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Abstract

Purpose

Diagnosis of tuberculous uveitis (TBU) is often challenging and is usually made after excluding other causes of uveitis. We analysed the characteristics of TBU and variables associated with visual outcome.

Methods

A retrospective, observational analysis was performed in patients with presumptive TBU who were started on specific TB treatment between January 2006 and June 2016. Demographic, clinical, radiological, analytical and ophthalmic examination variables were studied. After completing TB treatment, a follow-up of at least 9 months was performed. A univariate and logistic regression analysis was applied to identify the variables associated with visual acuity and recurrences of uveitis.

Results

Forty affected eyes of 24 individuals were identified; 79% of patients were diagnosed during the last 3 years of the study period. Median delay from onset of symptoms to diagnosis was 12 weeks. Loss of visual acuity was the most frequent symptom (87.5%). Posterior uveitis was the most frequent localization (72.9%); 19 patients (79.2%) presented at least one of the Gupta signs predictive of TBU, but there were no confirmed diagnoses.

Outcome

There was improvement in visual acuity in 74.4% of the eyes, but a complete response was achieved only in 56.4%. There was recurrence in two patients. The initiation of treatment ≥ 24 weeks after onset of symptoms was significantly associated with no improvement (p = 0.026).

Conclusion

TBU can cause permanent damage to visual acuity, particularly in patients with delayed diagnosis. A prompt initiation of systemic TB treatment is essential to improve visual prognosis.
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Metadaten
Titel
Early treatment of tuberculous uveitis improves visual outcome: a 10-year cohort study
verfasst von
Luis Anibarro
Eliana Cortés
Ana Chouza
Alberto Parafita-Fernández
Juan Carlos García
Alberto Pena
Carlos Fernández-Cid
África González-Fernández
Publikationsdatum
04.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 4/2018
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-018-1161-1

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