Relapse in ocular tuberculosis: relapse rate, risk factors and clinical management in a non-endemic country.

Autor:	Putera I; Department of Ophthalmology, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia i.putera@erasmusmc.nl s.rombach@erasmusmc.nl.; Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands.; Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands.; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Ten Berge JCEM; Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Thiadens AAHJ; Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Dik WA; Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Agrawal R; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.; National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK.; Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore.; Duke NUS Medical School, Singapore., van Hagen PM; Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands.; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands., La Distia Nora R; Department of Ophthalmology, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.; Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands., Rombach SM; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands i.putera@erasmusmc.nl s.rombach@erasmusmc.nl.
Jazyk:	angličtina
Zdroj:	The British journal of ophthalmology [Br J Ophthalmol] 2024 Nov 22; Vol. 108 (12), pp. 1642-1651. Date of Electronic Publication: 2024 Nov 22.
DOI:	10.1136/bjo-2024-325207
Abstrakt:	Aims: To assess the risk of uveitis relapse in ocular tuberculosis (OTB) following clinical inactivity, to analyse clinical factors associated with relapses and to describe the management strategies for relapses. Methods: A retrospective study was conducted on a 10-year patient registry of patients with OTB diagnosed at Erasmus MC in Rotterdam, The Netherlands. Time-to-relapse of uveitis was evaluated with Kaplan-Meier curve and risk factors for relapses were analysed. Results: 93 OTB cases were identified, of which 75 patients achieved clinical inactivity following treatment. The median time to achieve uveitis inactivity was 3.97 months. During a median follow-up of 20.7 months (Q1-Q3: 5.2-81.2) after clinical inactivity, uveitis relapse occurred in 25 of these 75 patients (33.3%). Patients who were considered poor treatment responders for their initial uveitis episode had a significantly higher risk of relapse after achieving clinical inactivity than good responders (adjusted HR=3.84, 95% CI: 1.28 to 11.51). 13 of the 25 relapsed patients experienced multiple uveitis relapse episodes, accounting for 78 eye-relapse episodes during the entire observation period. Over half (46 out of 78, 59.0%) of these episodes were anterior uveitis. A significant number of uveitis relapse episodes (31 episodes, 39.7%) were effectively managed with topical corticosteroids. Conclusions: Our results suggest that approximately one-third of patients with OTB will experience relapse after achieving clinical inactivity. The initial disease course and poor response to treatment predict the likelihood of relapse in the long-term follow-up. Topical corticosteroids were particularly effective in relapse presenting as anterior uveitis. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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