Anti-tubercular therapy for intraocular tuberculosis: A systematic review and meta-analysis

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• 作者：Ae Ra Kee ; MBBS^a ; Julio J. Gonzalez-Lopez ; PhD^b ; ^{juliojose.gonzalez@live.com" class="auth_mail" title="E-mail the corresponding author} ; Aws Al-Hity ; FRCOphth^b ; Bhaskar Gupta^c ; ^d ; Cecilia S. Lee ; MD^e ; Dinesh Visva Gunasekeran ; MBBS^f ; Nirmal Jayabalan ; PhD^g ; Robert Grant ; MD^h ; Onn Min Kon ; MDⁱ ; Vishali Gupta ; MD^j ; Mark Westcott ; FRCOphth^d ; Carlos Pavesio ; FRCOphth^d ; Rupesh Agrawal ; FRCS ; MD(Res)^f ; ^g ; ^d ; ^{rupesh_agrawal@ttsh.com.sg" class="auth_mail" title="E-mail the corresponding author}
• 关键词：tuberculosis ; intraocular ; uveitis ; anti-tubercular therapy
• 刊名：Survey of Ophthalmology
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：61
• 期：5
• 页码：628-653
• 全文大小：2598 K

文摘

Intraocular tuberculosis remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyze the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular tuberculosis and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1,917 patients. Nonrecurrence of inflammation was observed in pooled estimate of 84% of ATT-treated patients (95% CI 79–89). There was minimal difference in the outcome between patients treated with ATT alone (85% successful outcome; 95% CI 25–100) and those with concomitant systemic corticosteroid (82%; 95% CI 73–90). The use of ATT may be of benefit to patients with suspected intraocular tuberculosis; however, this conclusion is limited by the lack of control group analysis and standardized recruitment and treatment protocols. We propose further prospective studies to better establish the efficacy of ATT and ascertain the factors associated with favorable treatment outcomes.