Ocular Tuberculosis

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The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform

Rupesh Agrawal - One of the best experts on this subject based on the ideXlab platform.

Carlos Pavesio - One of the best experts on this subject based on the ideXlab platform.

  • Presumed Ocular Tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study
    Eye, 2020
    Co-Authors: Katherine Shirley, Carlos Pavesio, Samir Dowlut, Julie Silvestri, Barny Foot
    Abstract:

    Introduction Ocular Tuberculosis (TB) is an extrapulmonary manifestation of mycobacterium infection that most commonly presents as uveitis. This is the first prospective incidence study of presumed Ocular Tuberculosis performed in the United Kingdom (UK). Method New cases of Ocular Tuberculosis presenting to hospitals in the UK were prospectively ascertained between October 2016 and November 2017 with the aid of the British Ophthalmological Surveillance Unit (BOSU). Initial presentation data and 1-year follow-up data was collected using questionnaires. Results Forty-eight patients were recruited giving an overall incidence for Ocular TB of 0.73 per million population per annum. The origin of birth for 71% of the patients was a non-UK country and 87.5% had their initial diagnosis of TB made by an ophthalmologist. The most common first line treatment was isoniazid, rifampicin, ethambutol and pyrazinamide which 71% of patients were treated with 60% of patients were commenced on a reducing course of oral steroids. At 1-year follow-up, 29 patients (83%) had complete resolution of active clinical signs. Mean best corrected visual acuity (BCVA) at presentation was +0.41 LogMAR(SD = 0.62), compared to +0.31 LogMAR (SD = 0.56) at 12-month follow-up. Discussion It is increasingly the responsibility of the ophthalmologist to diagnose Ocular TB and although it remains a rare condition, consensus on diagnostic criteria and treatment is required. Increasing recognition and accessibility to gamma-interferon testing should enable earlier detection. Treatment with quadruple ATT treatment regimens for at least 6 months shows good clinical outcomes. However, it is still unclear whether steroid use is beneficial. Further large studies with longer follow-up would be warranted to answer these questions.

  • Current clinical management of Ocular Tuberculosis
    Expert Review of Ophthalmology, 2020
    Co-Authors: Ilaria Testi, Rupesh Agrawal, Vishali Gupta, Bjorn Kaijun Betzler, Onn Min Kon, Carlos Pavesio
    Abstract:

    ABSTRACTIntroduction: Management of Ocular Tuberculosis (OTB) poses a significant challenge due to heterogenous clinical presentations and persistent gaps in detection and treatment. The role of an...

  • Presumed Ocular Tuberculosis in the United Kingdom: a British Ophthalmological Surveillance Unit (BOSU) study.
    Eye (London England), 2020
    Co-Authors: Katherine Shirley, Carlos Pavesio, Samir Dowlut, Julie Silvestri, Barny Foot
    Abstract:

    Ocular Tuberculosis (TB) is an extrapulmonary manifestation of mycobacterium infection that most commonly presents as uveitis. This is the first prospective incidence study of presumed Ocular Tuberculosis performed in the United Kingdom (UK). New cases of Ocular Tuberculosis presenting to hospitals in the UK were prospectively ascertained between October 2016 and November 2017 with the aid of the British Ophthalmological Surveillance Unit (BOSU). Initial presentation data and 1-year follow-up data was collected using questionnaires. Forty-eight patients were recruited giving an overall incidence for Ocular TB of 0.73 per million population per annum. The origin of birth for 71% of the patients was a non-UK country and 87.5% had their initial diagnosis of TB made by an ophthalmologist. The most common first line treatment was isoniazid, rifampicin, ethambutol and pyrazinamide which 71% of patients were treated with 60% of patients were commenced on a reducing course of oral steroids. At 1-year follow-up, 29 patients (83%) had complete resolution of active clinical signs. Mean best corrected visual acuity (BCVA) at presentation was +0.41 LogMAR(SD = 0.62), compared to +0.31 LogMAR (SD = 0.56) at 12-month follow-up. It is increasingly the responsibility of the ophthalmologist to diagnose Ocular TB and although it remains a rare condition, consensus on diagnostic criteria and treatment is required. Increasing recognition and accessibility to gamma-interferon testing should enable earlier detection. Treatment with quadruple ATT treatment regimens for at least 6 months shows good clinical outcomes. However, it is still unclear whether steroid use is beneficial. Further large studies with longer follow-up would be warranted to answer these questions.

  • Ocular Tuberculosis: Where are we today?
    Indian journal of ophthalmology, 2020
    Co-Authors: Ilaria Testi, Rupesh Agrawal, Salil Mehta, Soumvaya Basu, Quan Nguyen, Carlos Pavesio, Vishali Gupta
    Abstract:

    Diagnosis and management of Ocular Tuberculosis (OTB) poses a significant challenge. Mixed Ocular tissue involvement and lack of agreement on best practice diagnostic tests together with the global variations in therapeutic management contributed to the existing uncertainties regarding the outcome of the disease. The current review aims to update recent progress on OTB. In particular, the Collaborative Ocular Tuberculosis Study (COTS) group recently standardized a nomenclature system for defining clinical phenotypes, and also proposed consensus guidelines and an algorithmic approach for management of different clinical phenotypes of OTB. Recent developments in experimental research and innovations in molecular diagnostics and imaging technology have provided a new understanding in the pathogenesis and natural history of the disease.

  • the role of anti tubercular therapy in patients with presumed Ocular Tuberculosis
    Ocular Immunology and Inflammation, 2015
    Co-Authors: Rupesh Agrawal, Mark Westcott, Bhaskar Gupta, Farzana Rahman, Sumita Phatak, Ioanna Triantafyllopoulou, Peter K F Addison, Julio J Gonzalezlopez, Carlos Pavesio
    Abstract:

    AbstractObjective: To analyze the factors affecting the treatment outcome in patients with presumed Ocular Tuberculosis on anti-tubercular therapy (ATT).Methods: Retrospective chart review of patients with presumed Ocular Tuberculosis seen at a tertiary referral eye care center in the United Kingdom. Failure was defined as recurrence of inflammation within 6 months of completion of ATT.Results: There were a total of 175 patients with presumed Ocular Tuberculosis who had ATT. Patients with intermediate uveitis or panuveitis and those on immunosuppressive therapy had higher odds of treatment failure (p < 0.05) while those with more than 9 months of ATT (77, 79.38%) had less likelihood of failure.Conclusion: We present the largest case series of patients with presumed Ocular Tuberculosis in a low endemic area treated with ATT. Longer duration of treatment resulted in reduced risk of recurrence of inflammation, whereas immunosuppression adversely affected the final treatment outcome.

Soumyava Basu - One of the best experts on this subject based on the ideXlab platform.

  • Pattern of Recurrent Inflammation following Anti-tubercular Therapy for Ocular Tuberculosis.
    Ocular immunology and inflammation, 2020
    Co-Authors: Prabhjot Kaur Multani, Rohit Ramesh Modi, Soumyava Basu
    Abstract:

    To investigate recurrence patterns following anti-tubercular therapy (ATT) in different anatomical presentations of Ocular Tuberculosis (OTB). Retrospective analysis of clinically diagnosed OTB pat...

  • Animal Models of Ocular Tuberculosis: Implications for Diagnosis and Treatment.
    Ocular immunology and inflammation, 2020
    Co-Authors: Soumyava Basu, Narsing A. Rao, Paul T. Elkington
    Abstract:

    The pathogenesis of Ocular Tuberculosis (TB) has remained unclear due to the challenges of performing mechanistic studies on clinical samples. Animal models have the potential to bridge these gaps ...

  • A zebrafish model for Ocular Tuberculosis.
    PloS one, 2018
    Co-Authors: Kevin K. Takaki, Lalita Ramakrishnan, Soumyava Basu
    Abstract:

    Ocular Tuberculosis (TB) commonly causes severe inflammation and vision loss in TB-endemic countries. The mechanism by which tuberculous infection becomes established in the eye is poorly understood. We have developed the zebrafish larva infected with Mycobacterium marinum as a model to study the early pathogenesis of Ocular TB. We find that hematogenous bacterial seeding of the eye occurs despite a functional blood retinal barrier. Prototypical early granulomas form in response to bacteria in the eye. These granulomas involve the retinal vasculature and retinal pigment epithelium-choroid complex which are characteristic locations for human Ocular TB. We find that peripheral blood monocytes are recruited to the nascent Ocular granuloma further suggesting that the immune privileged nature of the eye is breached by this inflammatory focus.

  • A Zebrafish Model for Ocular Tuberculosis
    2017
    Co-Authors: Kevin K. Takaki, Lalita Ramakrishnan, Soumyava Basu
    Abstract:

    Ocular Tuberculosis (TB) commonly causes severe inflammation and vision loss in TB-endemic countries. The mechanism by which tuberculous infection becomes established in the eye is poorly understood. We used Mycobacterium marinum-infected zebrafish larvae to study the early pathogenesis of Ocular TB and found hematogenous bacterial seeding of the eye despite a functional blood retinal barrier. Prototypical early granulomas formed that involved the retinal vasculature and retinal pigment epithelium-choroid complex; characteristic locations for human Ocular TB. Peripheral blood monocytes were recruited to the growing granuloma suggesting that the immune privileged nature of the eye is breached by this inflammatory focus.

  • Degree, duration, and causes of visual impairment in eyes affected with Ocular Tuberculosis
    Journal of ophthalmic inflammation and infection, 2014
    Co-Authors: Soumyava Basu, Rohit Ramesh Modi, Tapas Ranjan Padhi, Sirajum Monira, Nuzhat Choudhury, Neha Mohan, Praveen Kumar Balne, Savitri Sharma, Satya Ranjan Panigrahi
    Abstract:

    Background Ocular Tuberculosis (TB) can affect nearly every Ocular tissue, leading to a variety of vision-threatening clinical manifestations. The goal of this study is to estimate the degree, duration, and causes of visual impairment in eyes affected by Ocular TB.

Ilaria Testi - One of the best experts on this subject based on the ideXlab platform.

Mark Westcott - One of the best experts on this subject based on the ideXlab platform.

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