01/05/2022, 20:29 Diagnosis of Tuberculous Uveitis: Clinical Application of an Interferon-gamma Release Assay - ScienceDirect

Ophthalmology
Volume 116, Issue 7, July 2009, Pages 1391-1396

Original article

Diagnosis of Tuberculous Uveitis: Clinical Application of an

Interferon-gamma Release Assay
Presented as a poster at: the American Academy of Ophthalmology Annual Meeting, November 2008, Atlanta, Georgia.

Marcus Ang MBBS 1, Hla Myint Htoon PhD 2, Soon-Phaik Chee FRCOphth, FRCS (G) 1, 2, 3

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https://doi.org/10.1016/j.ophtha.2009.02.005 Get rights and content

Referred to by Soumyava Basu, Tapas Ranjan Padhi

Tuberculous Uveitis
Ophthalmology, Volume 117, Issue 5, May 2010, Pages 1049-1050

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Purpose
To determine the role of the QuantiFERON-TB Gold In-Tube (QFT) (Cellestis Inc., Carnegie,
Australia) assay in the diagnosis of tuberculosis (TB) uveitis.

Design
Retrospective cohort study.

Participants
The study included 157 patients with suspected TB uveitis seen over an 18-month period
(August 1, 2006, to February 31, 2007) at the Singapore National Eye Center (SNEC) uveitis
clinic.

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01/05/2022, 20:29 Diagnosis of Tuberculous Uveitis: Clinical Application of an Interferon-gamma Release Assay - ScienceDirect

Methods
We identified all cases of suspected TB uveitis in the above-mentioned time period and
reviewed all medical records of the cases. Clinical findings, type of treatment instituted,
response to treatment, and results of investigations such as QFT, tuberculin skin test (TST),
and chest x-rays were recorded. A novel method of using treatment response to determine the
presumed diagnosis of TB was used to estimate the accuracy of QFT and TST.

Main Outcome Measures

The positive likelihood ratio (LR+), negative likelihood ratio (LR−), and area under the receiver
operator characteristic curve (ROC) of the investigations were estimated.

Results
QFT is not superior to the TST in sensitivity as a screening test or first-line study in TB-
related uveitis; however, QFT is more specific than the TST in identifying infections by
Mycobacterium tuberculosis. Negative QFT tests should be interpreted with caution, because they
do not exclude the diagnosis.

Conclusions
The new QFT is only slightly superior to the TST in the diagnosis of TB uveitis. Thus, there is
an important role for interpreting the QFT together with the TST. This is the first and largest
study of its kind to evaluate the use of QFT in the clinical diagnosis of TB uveitis.

Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this
article.

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Citation Excerpt :
…Systemic or intra ocular steroid as an adjunct has a proven role in reducing the inflammation,however
studies have yielded diverse results. In a study published by Ang et al, no significant difference in
outcome was observed in patients treated concomitantly with antituberculous drugs and steroids versus
antituberculous drugs alone [11]. Optic neuropathy in tuberculosis occurs by various pathophysiological
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Manuscript no. 2008-1078.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this
article.

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