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The Collaborative Ocular Tuberculosis Study (COTS)-1 Report 3: Polymerase Chain Reaction in the Diagnosis and Management of Tubercular Uveitis: Global Trends |
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| Authors: | Aniruddha Agarwal Rupesh Agrawal Dinesh Visva Gunasekaran Dhananjay Raje Bhaskar Gupta Kanika Aggarwal |
| Affiliation: | 1. Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India;2. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore;3. Moorfields Eye Hospital, NHS Foundation Trust, London, UK;4. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;5. Singapore Eye Research Institute, Singapore, Singapore;6. CSTAT, Royal Statistician Society, London, UK;7. Royal Berkshire Hospital, NHS Foundation Trust, Reading, UK |
| Abstract: | Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario. |
| Keywords: | Anti-tubercular therapy choroidal tuberculoma choroiditis polymerase chain reaction tuberculosis |