CLINICAL PREDICTORS OF TUBERCULAR RETINAL VASCULITIS IN A HIGH-ENDEMIC COUNTRY.
Journal
Retina (Philadelphia, Pa.)
ISSN: 1539-2864
Titre abrégé: Retina
Pays: United States
ID NLM: 8309919
Informations de publication
Date de publication:
01 Feb 2021
01 Feb 2021
Historique:
pubmed:
10
5
2020
medline:
15
9
2021
entrez:
9
5
2020
Statut:
ppublish
Résumé
To determine clinical signs suggestive of tubercular etiology in retinal vasculitis. A retrospective comparative study of patients who presented with retinal vasculitis at three tertiary care centers in India. All patients underwent detailed clinical evaluation and tailored laboratory investigations for etiological diagnosis. Tubercular etiology was diagnosed on basis on the presence of retinal periphlebitis in association with ancillary evidence of systemic tuberculosis and exclusion of nontuberculosis entities. Patients with tubercular (Group A) and nontubercular (Group B) etiology were compared for demographic characteristics, supportive diagnostic evidence, and specific ocular signs. Statistical analysis was performed at 5% confidence levels. Of the 114 patients diagnosed with retinal vasculitis, Group A had 69 patients (100 eyes) and Group B had 45 patients (75 eyes). Active or healed subvascular lesions (P ≤ 0.0001), focal vascular tortuosity (P ≤ 0.0001), and occlusive vasculitis (P = 0.002) were significantly more common in Group A patients than in Group B patients. All three were independent predictors of tubercular etiology on multivariate regression analysis. The presence of healed or active subvascular lesions, focal vascular tortuosity, and occlusive vasculitis could be predictive of tubercular etiology in retinal vasculitis.
Identifiants
pubmed: 32383841
pii: 00006982-202102000-00026
doi: 10.1097/IAE.0000000000002829
doi:
Substances chimiques
Antitubercular Agents
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
438-444Références
Abu El-Asrar AM, Herbort CP, Tabbara KF. Retinal vasculitis. Ocul Immunol Inflamm 2005;13:415–33.
Hughes EH, Dick AD. The pathology and pathogenesis of retinal vasculitis. Neuropathol Appl Neurobiol 2003;29:325–340.
Rosenbaum JT, Ku J, Ali A, et al. Patients with retinal vasculitis rarely suffer from systemic vasculitis. Semin Arthritis Rheum 2012;41:859–865.
Gupta A, Bansal R, Gupta V, et al. Ocular signs predictive of tubercular uveitis. Am J Ophthalmol 2010;149:562–570.
Brunner DR, Zweifel SA, Barthelmes D, et al. Review of people with retinal vasculitis and positive QuantiFERON-TB Gold test in an area non endemic for tuberculosis. Int Ophthalmol 2018;38:2389–2395.
Mahyudin M, Choo MM, Ramli NM, Omar SS. Ocular tuberculosis initially presenting as central retinal vein occlusion. Case Rep Ophthalmol 2010;1:30–35.
O'Hearn TM, Fawzi A, Esmaili D, et al. Presumed ocular tuberculosis presenting as a branch retinal vein occlusion in the absence of retinal vasculitis or uveitis. Br J Ophthalmol 2007;91:981–982.
Gupta V, Gupta A, Rao NA. Intra-ocular tuberculosis—an update. Surv Ophthalmol 2007;52:561–587.
Herbot CP, Rao NA, Mochizuki M. Members of scientific committee of first international workshop on Ocular Sarcoidosis; International criteria for the diagnosis of ocular sarcoidosis; results of the first International Workshop on Ocular Sarcoidosis. Ocul Immunol Inflamm 2009;17:160–169.
Wroblewski KJ, Hidayat AA, Neafie RC, et al. Ocular tuberculosis: a clinicopathologic and molecular study. Ophthalmology 2011;118:772–777.
Barik MR, Rath S, Modi R, et al. Normalised quantitative polymerase chain reaction for diagnosis of tuberculosis-associated uveitis. Tuberculosis 2018;110:30–35.
Teixeira HC, Abramo C, Munk ME. Immunological diagnosis of tuberculosis: problems and strategies for success. Jornal Brasileiro de Pneumologia 2007;33:323–334.
Gupta A, Gupta V, Arora S, et al. PCR-positive tubercular retinal vasculitis. Clinical characteristics and management. Retina 2001;21:435–444.
Verhoeff FH, Simpson GV. Tubercle within central retinal vein: haemorrhagic glaucoma; periphlebitis retinalis in other eye. Arch Ophthalmol 1940;24:645.
Saini JS, Mukherjee AK, Nadkarni N. Primary tuberculosis of the retina. Br J Ophthalmol 1986;70:533–535.
Basu S, Mittal R, Balne PK, et al. Intraretinal Tuberculosis Ophthalmol 2012;119:2192–2193e1.
Lammie GA, Hewlett RH, Schoeman JF, Donald PR. Tuberculous cerebrovascular disease. A review. J Infect 2009;59:156–166.
Thayil SM, Albini TA, Nazari H, et al. Local ischemia and increased expression of vascular endothelial growth factor following ocular dissemination of Mycobacterium tuberculosis. PLoS One 2011;6:e28383.
Hartnett ME, Martiniuk D, Byfield G, et al. Neutralizing VEGF decreases tortuosity and alters endothelial cell division orientation in arterioles and veins in a rat model of ROP: relevance to plus disease. Invest Ophthalmol Vis Sci 2008;49:3107–3114.
Jabs DA, Busingye J. Approach to the diagnosis of the uveitides. Am J Ophthalmol 2013;156:228–236.
de Parisot A, Kodjikian L, Errera MH, et al. Randomized controlled trial evaluating a standardized strategy for uveitis etiologic diagnosis (ULISSE). Am J Ophthalmol 2017;178:176–185.
Gunasekeran DV, Agrawal R, Agarwal A, et al. The collaborative ocular tuberculosis study (COTS)-1: a multinational review of 251 patients with tubercular retinal vasculitis. Retina 2019;39:1623–1630.
Agarwal A, Karkhur S, Aggarwal K, et al. Epidemiology and clinical features of inflammatory retinal vascular occlusions: pooled data from two tertiary-referral institutions. Clin Exp Ophthalmol 2018;46:62–74.