Diagnostic Criteria And Clinical Manifestations Of Presumed Latent Tuberculosis-Related Uveitis In A Bacille Calmette-Guerin Vaccinatinated Community

Purpose: The wide range of clinical manifestations of presumed latent tuberculosis-related uveitis (TRU) make its diagnosis difficult in an endemic community. We described the ocular manifestations of patients with TRU, and we evaluated the correlation between skin induration value of tuberculin skin test (TST) and tuberculosis antigens tube value of QuantiFERON®-TB Gold (QFT) test in a Bacille Calmette-Guerin (BCG) vaccinated community. Methods: This was a prospective 1-year study in a tertiary referral center. 85 patients,47 (55.3 %) female diagnosed with TRU were included. Mean (standard deviation, SD) age was 52.9 (13.6) years. TST, QFT and pulmonary X-ray were performed. Other possible etiologies of uveitis were ruled-out. Standard anti-tuberculosis therapy (ATT) was started, and response to ATT was monitored. Statistical analysis was performed by using SPSS for Windows 13.0.1 (SPSS Inc., Chicago, IL, USA) Pearson correlation coefficient (r) was used for analysis. p Results: 43 patients (50.6%) had bilateral involvement. The most common ocular manifestation was anterior uveitis (78.8 %) followed by vitritis, panuveitis, papillitis, vasculitis, chorioretinitis and scleritis. The mean (SD) value of TST was 16.53 (6.05) mm and the mean (SD) value of QFT was 8.06 (4.53) IU/ml. Pulmonary X-ray results were normal. All the patients responded to ATT. No statistically significant correlation was found between TST and QFT. (r= 0.105, p=0.498) Conclusions: There is no pathognomonic clinical manifestation of TRU in an endemic, BCG vaccinated community. Presence of bilateral anterior uveitis, positive results for both TST and QFT, and positive response to ATT support the diagnosis of TRU in an endemic, BCG vaccinated community