Skip to main content
Erschienen in: International Ophthalmology 6/2018

13.10.2017 | Original Paper

Review of people with retinal vasculitis and positive QuantiFERON®-TB Gold test in an area nonendemic for tuberculosis

verfasst von: David R. Brunner, Sandrine A. Zweifel, Daniel Barthelmes, Fabio Meier, Christian Böni

Erschienen in: International Ophthalmology | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the frequency of a positive QuantiFERON®-TB Gold test (quantiferon) among patients with retinal vasculitis in an area nonendemic for tuberculosis (TB); to review clinical characteristics and management of affected individuals.

Methods

Consecutive patients with retinal vasculitis and a positive quantiferon were retrospectively analyzed. Demographics, clinical data, laboratory, imaging findings, and therapy were evaluated.

Results

Among 49 patients with retinal vasculitis, 12 (24%) had a positive quantiferon. Median age was 37 years, there were five female patients. Five individuals (42%) had previously lived in a country endemic for TB. Retinal vasculitis was occlusive in six patients (50%). On chest imaging, pulmonary tuberculosis was suspected in one patient (8.3%). Treatment modalities included full antitubercular treatment (n = 1), isoniazid prophylaxis (n = 6), systemic corticosteroids (n = 8), and laser treatment (n = 5). After a median follow-up of 27.5 months, inflammation was inactive (n = 6) or recurrently present (n = 6). No patient lost ≥ 2 lines of best-corrected visual acuity during follow-up.

Conclusions

The quantiferon test is recommended in the evaluation of people with retinal vasculitis. Interpretation of a positive result can be challenging in a country nonendemic for TB. The majority of patients with quantiferon-positive retinal vasculitis were found to have latent TB.
Literatur
1.
Zurück zum Zitat Raviglione M, Sulis G (2016) Tuberculosis 2015: burden, challenges and strategy for control and elimination. Infect Dis Rep 8:6570CrossRef Raviglione M, Sulis G (2016) Tuberculosis 2015: burden, challenges and strategy for control and elimination. Infect Dis Rep 8:6570CrossRef
2.
Zurück zum Zitat Bouza E, Merino P, Munoz P, Sanchez-Carrillo C, Yanez J, Cortes C (1997) Ocular tuberculosis. A prospective study in a general hospital. Medicine (Baltimore) 76:53–61CrossRef Bouza E, Merino P, Munoz P, Sanchez-Carrillo C, Yanez J, Cortes C (1997) Ocular tuberculosis. A prospective study in a general hospital. Medicine (Baltimore) 76:53–61CrossRef
3.
Zurück zum Zitat Donahue HC (1967) Ophthalmologic experience in a tuberculosis sanatorium. Am J Ophthalmol 64:742–748CrossRef Donahue HC (1967) Ophthalmologic experience in a tuberculosis sanatorium. Am J Ophthalmol 64:742–748CrossRef
4.
Zurück zum Zitat Gupta V, Shoughy SS, Mahajan S, Khairallah M, Rosenbaum JT, Curi A, Tabbara KF (2015) Clinics of ocular tuberculosis. Ocul Immunol Inflamm 23:14–24CrossRef Gupta V, Shoughy SS, Mahajan S, Khairallah M, Rosenbaum JT, Curi A, Tabbara KF (2015) Clinics of ocular tuberculosis. Ocul Immunol Inflamm 23:14–24CrossRef
5.
Zurück zum Zitat Singh R, Gupta V, Gupta A (2004) Pattern of uveitis in a referral eye clinic in north India. Indian J Ophthalmol 52:121–125 Singh R, Gupta V, Gupta A (2004) Pattern of uveitis in a referral eye clinic in north India. Indian J Ophthalmol 52:121–125
6.
Zurück zum Zitat Cambau E, Drancourt M (2014) Steps towards the discovery of Mycobacterium tuberculosis by Robert Koch, 1882. Clin Microbiol Infect 20:196–201CrossRef Cambau E, Drancourt M (2014) Steps towards the discovery of Mycobacterium tuberculosis by Robert Koch, 1882. Clin Microbiol Infect 20:196–201CrossRef
7.
Zurück zum Zitat Getahun H, Matteelli A, Chaisson RE, Raviglione M (2015) Latent Mycobacterium tuberculosis infection. N Engl J Med 372:2127–2135CrossRef Getahun H, Matteelli A, Chaisson RE, Raviglione M (2015) Latent Mycobacterium tuberculosis infection. N Engl J Med 372:2127–2135CrossRef
8.
Zurück zum Zitat Gupta V, Gupta A, Rao NA (2007) Intraocular tuberculosis—an update. Surv Ophthalmol 52:561–587CrossRef Gupta V, Gupta A, Rao NA (2007) Intraocular tuberculosis—an update. Surv Ophthalmol 52:561–587CrossRef
9.
Zurück zum Zitat La Distia Nora R, Van Velthoven ME, Ten Dam-Van Loon NH, Misotten T, Bakker M, Van Hagen MP, Rothova A (2014) Clinical manifestations of patients with intraocular inflammation and positive QuantiFERON-TB gold in-tube test in a country nonendemic for tuberculosis. Am J Ophthalmol 157:754–761CrossRef La Distia Nora R, Van Velthoven ME, Ten Dam-Van Loon NH, Misotten T, Bakker M, Van Hagen MP, Rothova A (2014) Clinical manifestations of patients with intraocular inflammation and positive QuantiFERON-TB gold in-tube test in a country nonendemic for tuberculosis. Am J Ophthalmol 157:754–761CrossRef
11.
Zurück zum Zitat Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature Working G (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516CrossRef Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature Working G (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516CrossRef
12.
Zurück zum Zitat Cutrufello NJ, Karakousis PC, Fishler J, Albini TA (2010) Intraocular tuberculosis. Ocul Immunol Inflamm 18:281–291CrossRef Cutrufello NJ, Karakousis PC, Fishler J, Albini TA (2010) Intraocular tuberculosis. Ocul Immunol Inflamm 18:281–291CrossRef
13.
Zurück zum Zitat Gineys R, Bodaghi B, Carcelain G, Cassoux N, Le Boutin TH, Amoura Z, Lehoang P, Trad S (2011) QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol 152(433–440):e431 Gineys R, Bodaghi B, Carcelain G, Cassoux N, Le Boutin TH, Amoura Z, Lehoang P, Trad S (2011) QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol 152(433–440):e431
14.
Zurück zum Zitat Vos AG, Wassenberg MW, De Hoog J, Oosterheert JJ (2013) Diagnosis and treatment of tuberculous uveitis in a low endemic setting. Int J Infect Dis 17:e993–e999CrossRef Vos AG, Wassenberg MW, De Hoog J, Oosterheert JJ (2013) Diagnosis and treatment of tuberculous uveitis in a low endemic setting. Int J Infect Dis 17:e993–e999CrossRef
15.
Zurück zum Zitat Lou SM, Larkin KL, Winthrop K, Rosenbaum JT, Uveitis Specialists Study G (2015) Lack of consensus in the diagnosis and treatment for ocular tuberculosis among uveitis specialists. Ocul Immunol Inflamm 23:25–31CrossRef Lou SM, Larkin KL, Winthrop K, Rosenbaum JT, Uveitis Specialists Study G (2015) Lack of consensus in the diagnosis and treatment for ocular tuberculosis among uveitis specialists. Ocul Immunol Inflamm 23:25–31CrossRef
16.
Zurück zum Zitat Kee AR, Gonzalez-Lopez JJ, Al-Hity A, Gupta B, Lee CS, Gunasekeran DV, Jayabalan N, Grant R, Kon OM, Gupta V, Westcott M, Pavesio C, Agrawal R (2016) Anti-tubercular therapy for intraocular tuberculosis: a systematic review and meta-analysis. Surv Ophthalmol 61:628–653CrossRef Kee AR, Gonzalez-Lopez JJ, Al-Hity A, Gupta B, Lee CS, Gunasekeran DV, Jayabalan N, Grant R, Kon OM, Gupta V, Westcott M, Pavesio C, Agrawal R (2016) Anti-tubercular therapy for intraocular tuberculosis: a systematic review and meta-analysis. Surv Ophthalmol 61:628–653CrossRef
17.
Zurück zum Zitat Gupta A, Gupta V (2005) Tubercular posterior uveitis. Int Ophthalmol Clin 45:71–88CrossRef Gupta A, Gupta V (2005) Tubercular posterior uveitis. Int Ophthalmol Clin 45:71–88CrossRef
18.
Zurück zum Zitat Gupta A, Bansal R, Gupta V, Sharma A, Bambery P (2010) Ocular signs predictive of tubercular uveitis. Am J Ophthalmol 149:562–570CrossRef Gupta A, Bansal R, Gupta V, Sharma A, Bambery P (2010) Ocular signs predictive of tubercular uveitis. Am J Ophthalmol 149:562–570CrossRef
19.
Zurück zum Zitat Gupta A, Gupta V, Arora S, Dogra MR, Bambery P (2001) PCR-positive tubercular retinal vasculitis: clinical characteristics and management. Retina 21:435–444CrossRef Gupta A, Gupta V, Arora S, Dogra MR, Bambery P (2001) PCR-positive tubercular retinal vasculitis: clinical characteristics and management. Retina 21:435–444CrossRef
20.
Zurück zum Zitat Das T, Pathengay A, Hussain N, Biswas J (2010) Eales’ disease: diagnosis and management. Eye 24:472–482CrossRef Das T, Pathengay A, Hussain N, Biswas J (2010) Eales’ disease: diagnosis and management. Eye 24:472–482CrossRef
21.
Zurück zum Zitat Biswas J, K RR, Pal B, Gondhale HP, Kharel Sitaula R (2017) Long-term outcomes of a large cohort of patients with Eales’ disease. Ocul Immunol Inflamm 27:1–7 Biswas J, K RR, Pal B, Gondhale HP, Kharel Sitaula R (2017) Long-term outcomes of a large cohort of patients with Eales’ disease. Ocul Immunol Inflamm 27:1–7
22.
Zurück zum Zitat Singh R, Toor P, Parchand S, Sharma K, Gupta V, Gupta A (2012) Quantitative polymerase chain reaction for Mycobacterium tuberculosis in so-called Eales’ disease. Ocul Immunol Inflamm 20:153–157CrossRef Singh R, Toor P, Parchand S, Sharma K, Gupta V, Gupta A (2012) Quantitative polymerase chain reaction for Mycobacterium tuberculosis in so-called Eales’ disease. Ocul Immunol Inflamm 20:153–157CrossRef
23.
Zurück zum Zitat Singh UB, Mohapatra S, Wagh VK, Porwal C, Kaushik A (2015) Association of Mycobacterium tuberculosis in the causation of Eales’ disease: an institutional experience. Indian J Med Microbiol 33(Suppl):43–45CrossRef Singh UB, Mohapatra S, Wagh VK, Porwal C, Kaushik A (2015) Association of Mycobacterium tuberculosis in the causation of Eales’ disease: an institutional experience. Indian J Med Microbiol 33(Suppl):43–45CrossRef
Metadaten
Titel
Review of people with retinal vasculitis and positive QuantiFERON®-TB Gold test in an area nonendemic for tuberculosis
verfasst von
David R. Brunner
Sandrine A. Zweifel
Daniel Barthelmes
Fabio Meier
Christian Böni
Publikationsdatum
13.10.2017
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 6/2018
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-017-0739-4

Weitere Artikel der Ausgabe 6/2018

International Ophthalmology 6/2018 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.