Outcome of anti-tubercular therapy with adjunctive use of systemic corticosteroids in patients with tuberculous anterior scleritis.
Purpose
To assess the outcome of patients with tuberculous anterior scleritis treated with anti-tubercular therapy with concomitant use of systemic corticosteroids.
Methods
Medical records of 42 consecutive patients with tuberculous anterior scleritis were reviewed retrospectively who presented from January 2018 to January 2020.Each patient underwent complete ophthalmic examination, systemic evaluation, laboratory investigations and was tested positive for tuberculin skin test (10 mm of induration or more)at 48 to 72 hours as well as QuantiFERON-TB Gold test. Other known causes of anterior scleritis were ruled out. All patients received anti-tubercular therapy for total 12 months and systemic corticosteroid was started 1week after initiation of anti-tubercular therapy at 1mg/kg body weight dose initially which was tapered off within 4 to 6 weeks. Minimum one year of follow-up from the initiation of treatment was done in all patients and evaluated for the absence of active disease after treatment.
Results
57 eyes of 42 consecutive patients with a diagnosis of tuberculous anterior scleritis were included. There were 13 male and 29 female patients. Presentation was unilateral in 27 patients and bilateral in15 patients. Scleral involvement was nodular in 31patients and diffuse in 11 patients. All patients improved clinically within 3 weeks of initiation of treatment followed by complete resolution of scleritis within 6 weeks.
Conclusion
Adjunctive use of systemic corticosteroid with anti-tubercular therapy was well tolerated in our tubercular anterior scleritis patients with relatively early clinical improvement.
Conflict of interest
No
Authors 1
Last name
AFRIN
Initials of first name(s)
Maf
Department
Uveitis
City
Dhaka
Country
Bangladesh
Authors 2
Last name
Das
Initials of first name(s)
Raja
Department
Ophthalmology
City
Dhaka
Country
Bangladesh
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