Polymerase Chain Reaction and its Correlation with Clinical Features and Treatment Response in Tubercular Uveitis

Ocul Immunol Inflamm. 2018;26(6):845-852. doi: 10.1080/09273948.2017.1287925. Epub 2017 Jun 30.

Abstract

Purpose: Correlation of results of polymerase chain reaction for Mycobacterium tuberculosis (MTB PCR) with clinical features and treatment response in tubercular uveitis.

Methods: Retrospective case study.

Results: Among 56 patients, 31 (55.3%) had acute and 25 (44.6%) had chronic uveitis. Uveitis was unilateral in 40 (71.4%) and bilateral in the remaining 16 (28.6%). Anatomical subtypes of uveitis were: anterior in 10 (13.9%) eyes, intermediate in 9 (12.5%), posterior in 17 (23.6%), and pan uveitis in 36 (50%) eyes. MTB PCR was positive in 24 patients. There was an 80% correlation between clinical response to antitubercular therapy (ATT) and PCR results. Twenty-two patients with positive PCR had a good clinical response. The sensitivity and specificity was 73.3% and 92.3%, respectively.

Conclusions: The diagnosis of intraocular TB requires strong clinical suspicion with corroborative laboratory and radiological evidence. A positive PCR is reliable whereas negative results should be correlated with clinical features. An adequate response to ATT supports PCR results.

Keywords: PCR; tuberculosis; uveitis.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, Bacterial / genetics*
  • Antitubercular Agents / therapeutic use*
  • Bacterial Proteins / genetics*
  • Child
  • DNA, Bacterial / genetics*
  • Electrophoresis, Agar Gel
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / isolation & purification
  • Mycobacterium tuberculosis / metabolism
  • Polymerase Chain Reaction / methods*
  • Retrospective Studies
  • Tuberculosis, Ocular / complications*
  • Tuberculosis, Ocular / diagnosis
  • Tuberculosis, Ocular / microbiology
  • Uveitis / diagnosis
  • Uveitis / drug therapy
  • Uveitis / etiology*
  • Young Adult

Substances

  • Antigens, Bacterial
  • Antitubercular Agents
  • Bacterial Proteins
  • DNA, Bacterial
  • MPB64 protein, Mycobacterium