Medical Journal of Indonesia Vol. 31 No. 4 2022 FKUI
Interferon-Gamma Release Assay and Chest X-Ray to Classify Intraocular Tuberculosis among Clinically Undifferentiated Uveitis
Dublin Core
Title
Medical Journal of Indonesia Vol. 31 No. 4 2022 FKUI
Interferon-Gamma Release Assay and Chest X-Ray to Classify Intraocular Tuberculosis among Clinically Undifferentiated Uveitis
Interferon-Gamma Release Assay and Chest X-Ray to Classify Intraocular Tuberculosis among Clinically Undifferentiated Uveitis
Subject
interferon-gamma release assay, tuberculosis, uveitis, X-ray
Description
BACKGROUND Tuberculosis (TB) is a common cause of intraocular inflammation in
Indonesia. As no accurate biomarker can confirm the diagnosis, ophthalmologists
often rely on systemic findings, such as tuberculin skin test, interferon-gamma release
assay (IGRA), and chest X-ray (CXR) for TB suspicion. This study aimed to evaluate IGRA
and CXR in classifying intraocular TB among patients with a clinically undifferentiated
cause of uveitis.
METHODS This cross-sectional study included 116 patients (a total of 163 affected eyes)
with a clinically undifferentiated cause of uveitis. IGRA and CXR were performed as
part of the workup. Data on visual acuity, anterior chamber inflammation grade, and
anatomical classification of uveitis were recorded. As there were no confirmed ocular
tuberculosis (OTB) in our cases, eyes were classified into probable OTB, possible OTB,
and unclassified.
RESULTS Overall, 93 patients (80.2%) with a clinically undifferentiated cause of uveitis
had positive IGRA, whereas 10 (8.6%) had CXR results suggestive of TB. More than one-
third of the patients were blind (visual acuity <3/60), and panuveitis was the commonest
anatomical classification. A trend was identified in patients with panuveitis, who often
showed ≥2+ cell anterior chamber inflammation (p for trend = 0.023), according to
OTB criteria (probable OTB = 3/4, 75.0%; possible OTB = 44/67, 65.7%; unclassified =
2/9, 22.2%). Furthermore, the clinically undifferentiated uveitis cases were eligible to
be stratified into probable (8.6%) and possible (75.0%) OTB categories after IGRA and
CXR examinations.
CONCLUSIONS The combination of IGRA and CXR is valuable for classifying and
diagnosing TB-related uveitis. A multidisciplinary approach is essential when the cause
of uveitis is unknown.
Indonesia. As no accurate biomarker can confirm the diagnosis, ophthalmologists
often rely on systemic findings, such as tuberculin skin test, interferon-gamma release
assay (IGRA), and chest X-ray (CXR) for TB suspicion. This study aimed to evaluate IGRA
and CXR in classifying intraocular TB among patients with a clinically undifferentiated
cause of uveitis.
METHODS This cross-sectional study included 116 patients (a total of 163 affected eyes)
with a clinically undifferentiated cause of uveitis. IGRA and CXR were performed as
part of the workup. Data on visual acuity, anterior chamber inflammation grade, and
anatomical classification of uveitis were recorded. As there were no confirmed ocular
tuberculosis (OTB) in our cases, eyes were classified into probable OTB, possible OTB,
and unclassified.
RESULTS Overall, 93 patients (80.2%) with a clinically undifferentiated cause of uveitis
had positive IGRA, whereas 10 (8.6%) had CXR results suggestive of TB. More than one-
third of the patients were blind (visual acuity <3/60), and panuveitis was the commonest
anatomical classification. A trend was identified in patients with panuveitis, who often
showed ≥2+ cell anterior chamber inflammation (p for trend = 0.023), according to
OTB criteria (probable OTB = 3/4, 75.0%; possible OTB = 44/67, 65.7%; unclassified =
2/9, 22.2%). Furthermore, the clinically undifferentiated uveitis cases were eligible to
be stratified into probable (8.6%) and possible (75.0%) OTB categories after IGRA and
CXR examinations.
CONCLUSIONS The combination of IGRA and CXR is valuable for classifying and
diagnosing TB-related uveitis. A multidisciplinary approach is essential when the cause
of uveitis is unknown.
Creator
Mei Riasanti, Ikhwanuliman Putera, Priscilla Jessica, Muhammad Zakiy Waliyuddin, Faiz Alwan Tagar, Andini Karlina CH, Yulia Aziza, Made Susiyanti, Lukman Edwar, Ratna Sitompul, Rina La Distia Nora
Source
https://doi.org/10.13181/mji.oa.226324
Date
October 18, 2022
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Mei Riasanti, Ikhwanuliman Putera, Priscilla Jessica, Muhammad Zakiy Waliyuddin, Faiz Alwan Tagar, Andini Karlina CH, Yulia Aziza, Made Susiyanti, Lukman Edwar, Ratna Sitompul, Rina La Distia Nora, “Medical Journal of Indonesia Vol. 31 No. 4 2022 FKUI
Interferon-Gamma Release Assay and Chest X-Ray to Classify Intraocular Tuberculosis among Clinically Undifferentiated Uveitis,” Repository Horizon University Indonesia, accessed November 22, 2024, https://repository.horizon.ac.id/items/show/1093.
Interferon-Gamma Release Assay and Chest X-Ray to Classify Intraocular Tuberculosis among Clinically Undifferentiated Uveitis,” Repository Horizon University Indonesia, accessed November 22, 2024, https://repository.horizon.ac.id/items/show/1093.