The first 2 authors contributed to this work equally.
Clinical signs of uveitis associated with latent tuberculosis
Article first published online: 27 MAR 2012
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 40, Issue 7, pages 689–696, September/October 2012
How to Cite
Ang, M., Hedayatfar, A., Zhang, R. and Chee, S.-P. (2012), Clinical signs of uveitis associated with latent tuberculosis. Clinical & Experimental Ophthalmology, 40: 689–696. doi: 10.1111/j.1442-9071.2012.02766.x
Competing/conflicts of interest: No stated conflict of interest.
Funding sources: No stated funding sources.
- Issue published online: 9 OCT 2012
- Article first published online: 27 MAR 2012
- Accepted manuscript online: 2 FEB 2012 12:06PM EST
- Received 31 October 2011; accepted 1 January 2012.
- infectious disease;
Background: To identify the clinical ocular signs of uveitis associated with latent tuberculosis.
Design: Retrospective case-control study.
Participants: Consecutive patients from Singapore National Eye Centre Uveitis over 9 years. Sixty-two patients with uveitis associated with latent tuberculosis were compared with 72 matched controls diagnosed with other known uveitides.
Methods: Patients were categorized as: (A) predominantly anterior segment inflammation (anterior uveitides) and (B) predominantly posterior segment inflammation (intermediate, posterior or pan-uveitides). The diagnostic performance of combining these clinical signs with investigations such as interferon-gamma release assay positivity and chest X-ray results suggestive of pulmonary tuberculosis was done using area under the receiver operator characteristic curve.
Main Outcome Measures: Sensitivity, specificity and likelihood of association with tuberculosis of various clinical signs.
Results: Extensive posterior synechiae and concomitant anterior scleritis in Group A; low-grade anterior chamber activity, retinal phlebitis and severe vitritis in Group B were significantly associated with latent tuberculosis. Combining these clinical signs with a positive interferon-gamma release assay and tuberculin skin test improved the diagnostic performance in both groups (area under the receiver operator characteristic curve for Group A = 0.779; Group B = 0.789).
Conclusion: Patients with a combination of suggestive clinical signs with positive interferon-gamma release assay and tuberculin skin test are more likely to be accurately diagnosed with uveitis associated with latent tuberculosis, which responds to anti-tuberculosis therapy.