Aniruddha Agarwal1, Rupesh Agrawal2,3,4,5, Dinesh Visva Gunasekaran2,3,4, Dhananjay Raje6, Bhaskar Gupta7, Kanika Aggarwal1, Somasheila L Murthy8, Mark Westcott3, Soon Phaik Chee4,5,9,10, Peter McCluskey11, Ho Su Ling2, Stephen Teoh2, Luca Cimino12, Jyotirmay Biswas13, Shishir Narain14, Manisha Agarwal15, Padmamalini Mahendradas16, Moncef Khairallah17, Nicholas Jones18, Ilknur Tugal-Tutkun19, Kalpana Babu20, Soumayava Basu21, Ester Carreño22, Richard Lee22, Hassan Al-Dhibi23, Bahram Bodaghi24, Alessandro Invernizzi25, Debra A Goldstein26, Carl P Herbort27, Talin Barisani-Asenbauer28, Julio J González-López29, Sofia Androudi30, Reema Bansal1, Bruttendu Moharana1, Sarakshi Mahajan1, Simona Esposti3, Anastasia Tasiopoulou3, Sengal Nadarajah3, Mamta Agarwal13, Sharanya Abraham13, Ruchi Vala16, Ramandeep Singh1, Aman Sharma31, Kusum Sharma32, Manfred Zierhut33, Onn Min Kon34, Emmett Cunningham35, Quan Dong Nguyen36, Carlos Pavesio3, Vishali Gupta1. 1. a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India. 2. b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore, Singapore. 3. c Moorfields Eye Hospital , NHS Foundation Trust , London , UK. 4. d Department of Ophthalmology , Yong Loo Lin School of Medicine, National University of Singapore , Singapore. 5. e Singapore Eye Research Institute , Singapore , Singapore. 6. f CSTAT , Royal Statistician Society , London, UK. 7. g Royal Berkshire Hospital , NHS Foundation Trust , Reading , UK. 8. h Tej Kohli Cornea Institute, LV Prasad Eye Institute , Kallam Anji Reddy Campus , Hyderabad , India. 9. i Singapore National Eye Centre , Singapore, Singapore. 10. j Duke-NUS Medical School , Singapore , Singapore. 11. k Department of Clinical Ophthalmology & Eye Health , Central Clinical School, Save Sight Institute, The University of Sydney , Sydney , Australia. 12. l Ocular Immunology Unit, Department of Ophthalmology Arcispedale-IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia , Italy. 13. m Sankara Nethralaya , Chennai , India. 14. n Shroff Eye Centre , New Delhi , India. 15. o Dr Shroff's Charity Eye Hospital Daryaganj , New Delhi , India. 16. p Narayana Nethralaya , Bangalore , India. 17. q Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir , Tunisia. 18. r University of Manchester , UK. 19. s Istanbul Faculty ofMedicine, Department of Ophthalmology , Istanbul University , Istanbul , Turkey. 20. t Department of Ophthalmology, Prabha Eye Clinic & Research centre , Vittala International Institute of Ophthalmology , Bangalore , India. 21. u LV Prasad Eye Institute , Bhubaneswar , India. 22. v Bristol Eye Hospital , UK. 23. w King Khaled Eye Specialist Hospital , Riyadh , Kingdom of Saudi Arabia. 24. x DHU SightRestore , University of Pierre andMarie Curie , Paris , France. 25. y Eye Clinic, Department of Biomedical and Clinical Science "L. Sacco" , Luigi Sacco Hospital, University of Milan , Milan , Italy. 26. z Feinberg School of Medicine, Department of Ophthalmology , Northwestern University , Chicago , Illinois , USA. 27. aa Centre for Ophthalmic Specialised Care & University of Lausanne , Lausanne , Switzerland. 28. ab Laura Bassi Centre of Expertise Ocuvac, Center for Pathophysiology, Immunology and Infectiology , Medical University of Vienna , Vienna , Austria. 29. ac Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcala , Spain. 30. ad Department of Ophthalmology , University of Thessaly , Volos , Greece. 31. ae Department of Rheumatology , PGIMER , Chandigarh, India. 32. af Department ofMicrobiology , PGIMER , Chandigarh, India. 33. ag Centre of Ophthalmology, University of Tuebingen , Tuebingen , Germany. 34. ah Chest and Allergy Clinic, St Mary's Hospital , Imperial College HealthcareNHS Trust , London , UK. 35. ai Francis I. Proctor Foundation for Research in Ophthalmology , University of California , San Francisco , USA. 36. aj Byers Eye Institute , Stanford University , Palo Alto , CA , USA.
Abstract
Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.
Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.
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