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Meta-Analysis
. 2016 Sep-Oct;61(5):628-53.
doi: 10.1016/j.survophthal.2016.03.001. Epub 2016 Mar 10.

Anti-tubercular therapy for intraocular tuberculosis: A systematic review and meta-analysis

Ae Ra Kee  1 , Julio J Gonzalez-Lopez  2 , Aws Al-Hity  3 , Bhaskar Gupta  4 , Cecilia S Lee  5 , Dinesh Visva Gunasekeran  6 , Nirmal Jayabalan  7 , Robert Grant  8 , Onn Min Kon  9 , Vishali Gupta  10 , Mark Westcott  11 , Carlos Pavesio  11 , Rupesh Agrawal  12
Affiliations
Meta-Analysis

Anti-tubercular therapy for intraocular tuberculosis: A systematic review and meta-analysis

Ae Ra Kee et al. Surv Ophthalmol. 2016 Sep-Oct.

Abstract

Intraocular tuberculosis remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyze the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular tuberculosis and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1,917 patients. Nonrecurrence of inflammation was observed in pooled estimate of 84% of ATT-treated patients (95% CI 79-89). There was minimal difference in the outcome between patients treated with ATT alone (85% successful outcome; 95% CI 25-100) and those with concomitant systemic corticosteroid (82%; 95% CI 73-90). The use of ATT may be of benefit to patients with suspected intraocular tuberculosis; however, this conclusion is limited by the lack of control group analysis and standardized recruitment and treatment protocols. We propose further prospective studies to better establish the efficacy of ATT and ascertain the factors associated with favorable treatment outcomes.

Keywords: anti-tubercular therapy; intraocular; tuberculosis; uveitis.

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Conflict of interest statement

There are no financial support and conflict of interest for any author.

Figures

Fig. 1
Fig. 1
Flowchart representing diagnostic and treatment conundrum in management of intraocular tuberculosis. HRCT, high-resolution chest tomography scan; IGRA, immunoglobulin release assay; PCR, polymerase chain reaction; PET, position emission tomography; Q-Gold, QuantiFERON-TB Gold In-Tube; TB, tuberculosis; TST, tuberculin skin test.
Fig. 2
Fig. 2
Study selection for systematic review. ATT, anti-tubercular therapy.
Fig. 3
Fig. 3
Forest plot showing the result of the random-effect meta-analysis of the effect size (ES) showing the proportion of patients with ocular tuberculosis that experimented a successful outcome following anti-tubercular therapy, by outcome.
Fig. 4
Fig. 4
Forest plot showing the result of the random-effect meta-analysis of the proportion of patients with ocular tuberculosis not receiving any anti-tubercular therapy that experimented a successful outcome, by outcome.
Fig. 5
Fig. 5
Forest plot showing the result of the random-effect meta-analysis of the proportion of patients with ocular tuberculosis treated with anti-tubercular therapy (ATT) that experimented a successful outcome, by treatment regime. ES, effect size.
Fig. 6
Fig. 6
Aspects of diagnostic criteria considered across the studies. ATT, anti-tubercular therapy; TB, tuberculosis.
See this image and copyright information in PMC

References

    1. Agrawal R, Gonzalez-Lopez JJ, Nobre-Cardoso J, et al. Predictive factors for treatment failure in patients with presumed ocular tuberculosis in an area of low endemic prevalence. Br J Ophthalmol. 2016;100(3):348–355. - PubMed
    1. Agrawal R, Gupta B, Gonzalez-Lopez JJ, et al. The role of anti-tubercular therapy in patients with presumed ocular tuberculosis. Ocul Immunol Inflamm. 2015;23(1):40–46. - PubMed
    1. Al-Mezaine HS, Al-Muammar A, Kangave D, et al. Clinical and optical coherence tomographic findings and outcome of treatment in patients with presumed tuberculous uveitis. Int Ophthalmol. 2008;28(6):413–423. - PubMed
    1. Alvarez GG, Roth VR, Hodge W. Ocular tuberculosis: diagnostic and treatment challenges. international journal of infectious diseases. Int J Infect Dis. 2009;13(4):432–435. - PubMed
    1. Ang M, Hedayatfar A, Wong W, et al. Duration of anti-tubercular therapy in uveitis associated with latent tuberculosis: a case-control study. Br J Ophthalmol. 2012;96(3):332–336. - PubMed

other cited material

    1. WHO. Tuberculosis. Access to the WHO global TB database 2015. Available from: http://www.who.int/tb/publications/global_report/en/
    1. Elimination DoT. Tuberculosis (TB): Treatment: Centers for Disease Control and Prevention (CDC) 2012. [Accessed December 9, 2011]; Available from: http://www.cdc.gov/tb/topic/treatment/
    1. Elimination DoT. Tuberculosis—Treatment. [Accessed May 1, 2015];Centers for Disease Control and Prevention. 2012 http://www.cdc.gov/tb/topic/treatment/default.htm.

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