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The following is a summary of “Systemic and ocular outcomes in TB-immunoreactive patients receiving immunomodulatory therapy for non-infectious uveitis: a case-control study,” published in the July 2024 issue of Ophthalmology by Balla et al.

Tuberculosis (TB) immunoreactivity, detected with tuberculin skin test (TST) or interferon gamma release assay (IGRA), can be present in latent, active, or cleared TB infections.

Researchers conducted a retrospective study comparing systemic and ocular outcomes in patients of non-infectious uveitis (NIU) with or without TB-immunoreactivity receiving immunomodulatory therapy (IMT).

They reviewed charts of patients with and without TB-immunoreactivity (TST±IGRA) receiving conventional IMT for at least 6 months to treat NIU. Patients with prior or concurrent anti-TB therapy were excluded, and the 2 groups were compared for systemic and ocular outcomes.

The result showed 36 cases and 70 gender- and age-matched controls. Only 1 case developed new-onset pulmonary or extrapulmonary TB, whereas no such cases were observed among the controls. The absolute risk increase for systemic TB reactivation was 0.028 (95% CI 0.005 to 0.051), with a number needed to harm calculated at 36. The incidence of persistent or recurrent intraocular inflammation (worsening by ≥2 grades) during IMT was similar between the groups (cases 18/36, controls 35/70, P=1.0). No change in the anatomical site of inflammation recurrence was observed in any of the cases, whereas 6 controls exhibited such changes (P=0.15). No new focal chorio-retinal lesions were identified in either group.

They concluded that in patients of TB-immunoreactive with NIU, conventional IMT posed a minimal risk of systemic TB reactivation and did not adversely affect ocular outcomes.

Source: bjo.bmj.com/content/early/2024/07/24/bjo-2024-325625