Raquel Gineys1, Bahram Bodaghi2, Ghislaine Carcelain3, Nathalie Cassoux4, Le Thi Huong Boutin5, Zahir Amoura5, Phuc Lehoang4, Salim Trad6. 1. Service d'Ophtalmologie, CHNO des Quinze-Vingts, Paris, France. 2. Service d'Ophtalmologie, Hôpital de la Pitié-Salpêtrière, Paris, France. Electronic address: bahram.bodaghi@psl.aphp.fr. 3. Laboratoire d'Immunologie Tissulaire et Cellulaire, Hôpital de la Pitié-Salpêtrière, Paris, France. 4. Service d'Ophtalmologie, Hôpital de la Pitié-Salpêtrière, Paris, France. 5. Inserm U945; Service de Médecine Interne, Hôpital de la Pitie-Salpêtriere, Paris, France. 6. Hôpital Ambroise Paré, Service de Médecine Interne, Boulogne-Billancourt, France.
Abstract
PURPOSE: To evaluate the accuracy of QuantiFERON-TB Gold testing in patients with presumptive tuberculosis-ocular inflammation. DESIGN: Prospective nonrandomized case series and clinical laboratory investigation. METHODS: Ninety-six consecutive patients presenting with ocular inflammation between January and October 2007 were tested using QuantiFERON-TB Gold. Positive patients received a 6-month anti-tuberculosis treatment. Patient follow-up ranged from 12 months to 24 months. Treatment was considered effective at the end of follow-up, in cases of no or a 2-point decrease of ocular inflammation (SUN criteria) and systemic corticosteroids stopped or tapered to 10 mg/day. RESULTS: Mean age was 51 ± 17 years. Types of ocular inflammation included scleritis (n = 7), panuveitis (n = 34), and posterior (n = 15), intermediate (n = 14), and anterior uveitis (n = 15). QuantiFERON-TB Gold was positive in 42 cases (44%), negative in 51 cases (53%), and undetermined in 3 cases (3%). Among positive QuantiFERON-TB Gold patients, 25 received a full anti-tuberculosis treatment, which was effective in 15 cases (60%). Associated systemic steroids were given to 6 patients and tapered to 10 mg/day or less in all cases. Median QuantiFERON-TB Gold value was significantly higher in the group with a successful therapeutic response (7.67 IU/mL [0.46 to 33.37]) compared to the group with treatment failure (1.22 IU/mL [0.61 to 4.4]), P = .026. CONCLUSION: Results of anti-tuberculosis treatment were encouraging in QuantiFERON-TB Gold-positive ocular inflammation, especially with values over 2 IU/mL in our study, suggesting that a higher cut-off value than that given by the manufacturer should be considered to better identify ocular inflammation that can benefit from full anti-tuberculosis treatment.
PURPOSE: To evaluate the accuracy of QuantiFERON-TB Gold testing in patients with presumptive tuberculosis-ocular inflammation. DESIGN: Prospective nonrandomized case series and clinical laboratory investigation. METHODS: Ninety-six consecutive patients presenting with ocular inflammation between January and October 2007 were tested using QuantiFERON-TB Gold. Positive patients received a 6-month anti-tuberculosis treatment. Patient follow-up ranged from 12 months to 24 months. Treatment was considered effective at the end of follow-up, in cases of no or a 2-point decrease of ocular inflammation (SUN criteria) and systemic corticosteroids stopped or tapered to 10 mg/day. RESULTS: Mean age was 51 ± 17 years. Types of ocular inflammation included scleritis (n = 7), panuveitis (n = 34), and posterior (n = 15), intermediate (n = 14), and anterior uveitis (n = 15). QuantiFERON-TB Gold was positive in 42 cases (44%), negative in 51 cases (53%), and undetermined in 3 cases (3%). Among positive QuantiFERON-TB Goldpatients, 25 received a full anti-tuberculosis treatment, which was effective in 15 cases (60%). Associated systemic steroids were given to 6 patients and tapered to 10 mg/day or less in all cases. Median QuantiFERON-TB Gold value was significantly higher in the group with a successful therapeutic response (7.67 IU/mL [0.46 to 33.37]) compared to the group with treatment failure (1.22 IU/mL [0.61 to 4.4]), P = .026. CONCLUSION: Results of anti-tuberculosis treatment were encouraging in QuantiFERON-TB Gold-positive ocular inflammation, especially with values over 2 IU/mL in our study, suggesting that a higher cut-off value than that given by the manufacturer should be considered to better identify ocular inflammation that can benefit from full anti-tuberculosis treatment.
Authors: R La Distia Nora; R Sitompul; M Bakker; M Susiyanti; L Edwar; S Sjamsoe; G Singh; M P van Hagen; A Rothova Journal: Eye (Lond) Date: 2017-11-03 Impact factor: 3.775
Authors: David R Brunner; Sandrine A Zweifel; Daniel Barthelmes; Fabio Meier; Christian Böni Journal: Int Ophthalmol Date: 2017-10-13 Impact factor: 2.031