Diagnosis and treatment for ocular tuberculosis among uveitis specialists: the international perspective

Abstract

Purpose: To assess the approach of international specialists, who primarily practice in tuberculosis-endemic areas, to ocular tuberculosis (TB).

Methods: International experts from India, Brazil, Taiwan, and more than 10 other countries were surveyed using two clinical cases and general questions.

Results: A total of 244 experts were sent a survey about the treatment and diagnosis of ocular tuberculosis; 65 responded (27%), of whom 34 were affiliated with practices in India, while 31 primarily practice at international sites outside of India and North America. The data from this survey were compared with the results of a similar survey sent to members of the American Uveitis Society. The survey provided normative data on how physicians evaluate patients with uveitis as well as opinions about ocular TB. Responses varied widely on topics such as tests to include in the workup of undifferentiated uveitis, initial therapy, and duration of treatment. Physicians from developing countries relied more on chest CT scans and tuberculin skin testing (TST) than their counterparts in developed countries.

Conclusions: The approach to diagnosis and management of TB is heterogeneous worldwide. However, there are substantial differences in the clinical approach to uveitis depending on the clinician's location of practice.

Keywords: Diagnostic criteria; international; post-test probability; pretest probability; treatment; tuberculosis; uveitis.