Developing a pathway for the diagnosis and management of ocular tuberculosis. The pan-LOndon Ocular tuberculosis Pathway-LOOP

Harry Petrushkin^{1

2}, Charanjit Sethi³, Jessica Potter⁴, Laura Martin⁵, Georgina Russell⁵, Veronica White⁶, Sofia Ajamil-Rodanes⁷, Michael Brown^{8

9}, Ronan Breen¹⁰, Marc Lipman¹¹, Ian Cropley¹¹, Rory McDermott¹², Anita Roche¹³, Helen Booth⁸, James Milburn¹⁴, Mathina Darmalingam¹⁵, Richard Lee⁷, Carlos Pavesio⁷, Miles Stanford¹⁶, Onn Min Kon⁵, Graham Bothamley¹⁷

Affiliations

¹ Uveitis and Scleritis Service, Moorfields Eye Hospital Foundation Trust, 162 City Rd, London, EC1V 2PD, UK. h.petrushkin@nhs.net.
² Rheumatology Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. h.petrushkin@nhs.net.
³ Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Rd, London, NW1 5QH, UK.
⁴ Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
⁵ Chest and Allergy Clinic, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
⁶ Department of Respiratory Medicine, King George V Building, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
⁷ Uveitis and Scleritis Service, Moorfields Eye Hospital Foundation Trust, 162 City Rd, London, EC1V 2PD, UK.
⁸ Division of Infection, UCLH, 149 Tottenham Court Road, London, W1T 7DN, UK.
⁹ North Central London South Hub TB Clinic, Whittington Hospital, Magdala Avenue, London, N19 5NF, UK.
¹⁰ Department of Respiratory Medicine, St Thomas' Hospital, Westminster Bridge Rd, Lambeth, London, SE1 7EH, UK.
¹¹ Department of Infectious Diseases, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.
¹² Department of Respiratory Medicine, Barts Health NHS Trust, Newham University Hospital, Glen Road, Plaistow, London, E13 8SL, UK.
¹³ South London Health Protection Team, Public Health England, Floor 3 C, Skipton House, 80 London Road, London, SE1 6LH, UK.
¹⁴ Infectious Disease Department, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK.
¹⁵ Department of Respiratory Medicine, Whipps Cross University Hospital, Barts Health NHS Trust, Whipps Cross Road, London, E11 1NR, UK.
¹⁶ Medical Eye Unit, St Thomas' Hospital, Westminster Bridge Rd, Lambeth, London, SE1 7EH, UK.
¹⁷ Department of Respiratory Medicine, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.

PMID: 31388132
PMCID: PMC7182550
DOI: 10.1038/s41433-019-0543-7

Review

Developing a pathway for the diagnosis and management of ocular tuberculosis. The pan-LOndon Ocular tuberculosis Pathway-LOOP

Harry Petrushkin et al. Eye (Lond). 2020 May.

. 2020 May;34(5):805-808.

doi: 10.1038/s41433-019-0543-7. Epub 2019 Aug 6.

Authors

Affiliations

¹ Uveitis and Scleritis Service, Moorfields Eye Hospital Foundation Trust, 162 City Rd, London, EC1V 2PD, UK. h.petrushkin@nhs.net.
² Rheumatology Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. h.petrushkin@nhs.net.
³ Western Eye Hospital, Imperial College Healthcare NHS Trust, 153-173 Marylebone Rd, London, NW1 5QH, UK.
⁴ Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
⁵ Chest and Allergy Clinic, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
⁶ Department of Respiratory Medicine, King George V Building, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
⁷ Uveitis and Scleritis Service, Moorfields Eye Hospital Foundation Trust, 162 City Rd, London, EC1V 2PD, UK.
⁸ Division of Infection, UCLH, 149 Tottenham Court Road, London, W1T 7DN, UK.
⁹ North Central London South Hub TB Clinic, Whittington Hospital, Magdala Avenue, London, N19 5NF, UK.
¹⁰ Department of Respiratory Medicine, St Thomas' Hospital, Westminster Bridge Rd, Lambeth, London, SE1 7EH, UK.
¹¹ Department of Infectious Diseases, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.
¹² Department of Respiratory Medicine, Barts Health NHS Trust, Newham University Hospital, Glen Road, Plaistow, London, E13 8SL, UK.
¹³ South London Health Protection Team, Public Health England, Floor 3 C, Skipton House, 80 London Road, London, SE1 6LH, UK.
¹⁴ Infectious Disease Department, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK.
¹⁵ Department of Respiratory Medicine, Whipps Cross University Hospital, Barts Health NHS Trust, Whipps Cross Road, London, E11 1NR, UK.
¹⁶ Medical Eye Unit, St Thomas' Hospital, Westminster Bridge Rd, Lambeth, London, SE1 7EH, UK.
¹⁷ Department of Respiratory Medicine, Homerton University Hospital, Homerton Row, London, E9 6SR, UK.

PMID: 31388132
PMCID: PMC7182550
DOI: 10.1038/s41433-019-0543-7

No abstract available

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

**Fig. 1**
The prevalence of tuberculosis in London in 2017. The yellow boxes superimposed represent the five TB services across London. The blue circles represent hospitals that have been involved in the development of the pathway. NE north east, NC north central, W west, SW south west, SE south east

**Fig. 2**
LOOP Version 1.9. The top dark-grey and light grey boxes (dark and light blue in online colour version) take place within the referring ophthalmology department. The bottom dark-grey boxes (grey in online colour version) take place at the local TB service. *A patient may not be treated if they decline ATT, the clinician considers treatment is not indicated, the risks of treatment outweigh the benefits or there is a contraindication to treatment. TB tuberculosis, *IGRA* interferon gamma release assay, CT computerised tomography, *PET-FDG* fluorodeoxyglucose positron emission tomography, *TST* tuberculin skin test, R rifampicin, H isoniazid, Z pyrazinamide, E ethambutol, M moxifloxacin

See this image and copyright information in PMC

References

1. Lou SM, Montgomery PA, Larkin KL, Winthrop K, Zierhut M, Rosenbaum JT, et al. Diagnosis and treatment for ocular tuberculosis among uveitis specialists: the international perspective. Ocul Immunol Inflamm. 2015;23:32–9. doi: 10.3109/09273948.2014.994784. - DOI - PubMed
1. Tomkins-Netzer O, Leong BCS, Zhang X, Lightman S, McCluskey PJ. Effect of antituberculous therapy on uveitis associated with latent tuberculosis. Am J Ophthalmol. 2018;190:164–70. doi: 10.1016/j.ajo.2018.03.032. - DOI - PubMed
1. Gunasekeran DV, Agrawal R, Agarwal A, Carreno E, Raje D, Aggarwal K, et al. THE COLLABORATIVE OCULAR TUBERCULOSIS STUDY (COTS)-1: a multinational review of 251 patients with tubercular retinal vasculitis. Retina. 2018;39:1623–30. doi: 10.1097/IAE.0000000000002194. - DOI - PubMed
1. Agarwal A, Agrawal R, Gunasekaran DV, Raje D, Gupta B, Aggarwal K, et al. The Collaborative Ocular Tuberculosis Study (COTS)-1 report 3: polymerase chain reaction in the diagnosis and management of tubercular uveitis: global trends. Ocul Immunol Inflamm. 2017;3:1–9. - PubMed
1. The European Medicine’s Agency final recommendation on quinolone and fluoroquinolone containing medicinal products. 2019. p. 2–4.

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Developing a pathway for the diagnosis and management of ocular tuberculosis. The pan-LOndon Ocular tuberculosis Pathway-LOOP

Affiliations

Developing a pathway for the diagnosis and management of ocular tuberculosis. The pan-LOndon Ocular tuberculosis Pathway-LOOP

Authors

Affiliations

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources