Anti-Tubercular Therapy in the Treatment of Tubercular Uveitis
Purpose
This updated meta-analysis quantitatively evaluates the efficacy of anti-tubercular therapy (ATT) and corticosteroid or immunosuppressive adjuncts in tubercular uveitis (TBU) patients.
Methods
Systematic search of PubMed, EMBASE and Cochrane Library for articles on ATT outcomes in TBU (1 Jan 2000 - 1 Aug 2021). Meta-analysis of proportions to calculate pooled estimates for six treatment outcomes
Results
49 studies reporting data for 4,017 TBU patients were included. In comparative studies, the odds ratio (OR) of inflammatory recurrence was 0.33 (95%CI: 0.19-0.60) for ATT vs no ATT. For ATT, pooled incidence of inflammatory recurrence, inflammatory reduction, complete resolution of inflammation and VA improvement were 13% (95%CI: 9-18), 81% (95%CI: 62-95), 83% (95%CI: 77-89), and 65% (95%CI: 51-78) respectively. Corticosteroids were tapered to <10 mg/day without inflammatory progression in 91% (95%CI: 78-99) of patients, 9% (95%CI: 6-13) were administered concomitant immunosuppressive agents
Conclusion
Treatment of TBU with ATT is associated with a high level of control or improvement of inflammation, followed by a two-third improvement in the risk of inflammatory recurrence in TBU patients; only one-seventh of TBU patients have recurrences during follow up. Visual acuity improved in most patients.
Conflict of interest
No
Authors 1
Last name
AGRAWAL
Initials of first name(s)
R
Department
National Healthcare Group Eye Institute, Tan Tock Seng Hospital
City
Singapore
Country
Singapore
Authors 2
Last name
BETZLER
Initials of first name(s)
BK
Department
Yong Loo Lin School of Medicine
City
Singapore
Country
Singapore
Authors 3
Last name
Putera
Initials of first name(s)
I
Department
University of Indonesia
City
Jakarta
Country
Indonesia
Authors 4
Last name
Testi
Initials of first name(s)
I
Department
Moorfield Eye Hospital
City
London
Country
United Kingdom
Authors 5
Last name
La Distia Nora
Initials of first name(s)
R
Department
University of Indonesia
City
Jakarta
Country
Indonesia
Authors 6
Last name
Kempen
Initials of first name(s)
J
Department
Massachusetts Eye and Ear
City
Boston
Country
United States
Authors 7
Last name
Pavesio
Initials of first name(s)
C
Department
Moorfields Eye Hospital
City
London
Country
United Kingdom
Authors 8
Last name
Gupta
Initials of first name(s)
V
Department
Advanced Eye Centre, PGIMER
City
Chandigarh
Country
India
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