Clinical Features and Predictors of Treatment Outcome in Patients with Ocular Tuberculosis from the Netherlands and Indonesia: The OculaR TB in Low versus High Endemic Countries (ORTEC) Study.

Autor: Putera I; Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia., Ten Berge JCEM; Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands., Thiadens AAHJ; Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands., Dik WA; Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands., Agrawal R; Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore.; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.; Duke NUS Medical School, Singapore, Singapore.; Ocular Infections and Antimicrobial Group, Singapore Eye Research Institute, Singapore, Singapore.; National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK., van Hagen PM; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands., La Distia Nora R; Department of Immunology, Clinical and Laboratory Medical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia., Rombach SM; Department of Internal Medicine Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 May 31, pp. 1-12. Date of Electronic Publication: 2024 May 31.
DOI: 10.1080/09273948.2024.2359614
Abstrakt: Purpose: To describe and compare clinical features, treatment approaches, and treatment outcomes of ocular tuberculosis (OTB) patients in the Netherlands, a low tuberculosis (TB)-endemic country, and Indonesia, a high TB-endemic country. We also aimed to identify predictors of treatment outcomes.
Methods: A medical chart review of 339 OTB patients ( n  = 93 from the Netherlands and n  = 246 from Indonesia) was performed. The primary outcome was response to treatment, whether with or without anti-tubercular treatment, after six months of treatment initiation (good versus poor responders).
Results: Indonesian OTB patients displayed a higher prevalence of chest radiograph findings indicative of TB infection ( p  < 0.001) and concurrent active systemic TB ( p  = 0.011). Indonesian cohort exhibited a more acute and severe disease profile, including uveitis duration ≤ 3 months ( p  < 0.001), blindness ( p  < 0.001), anterior chamber (AC) cells ≥ 2+ ( p  < 0.001), and posterior synechiae ( p  < 0.001). Overall proportions of good responders to treatment were 67.6% in the Netherlands and 71.5% in Indonesia. Presence of AC cell ≥ 2+ (adjusted odds ratio (aOR): 2.12, 95% CI: 1.09-4.14), choroidal lesions other than serpiginous-like choroiditis (SLC) or tuberculoma (aOR: 4.47, 95% CI: 1.18-16.90), and retinal vasculitis (aOR: 2.32, 95% CI: 1.10-4.90) at baseline were predictors for poor response to treatment.
Conclusions: Despite a more severe initial clinical presentation in the Indonesian cohort, the overall treatment outcomes of OTB was comparable in both cohorts. Three baseline clinical features were identified as predictors of treatment outcomes.
Databáze: MEDLINE
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