{"title":"眼内结核病辅助皮质类固醇治疗时间的特点和结果","authors":"Yaninsiri Ngathaweesuk , Sitrapa Janthayanont , Narumon Keorochana","doi":"10.1016/j.jctube.2024.100439","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Intraocular tuberculosis (IOTB) is a common site of extrapulmonary tuberculosis and a main cause of infectious uveitis. It can result in severe visual morbidity if not recognized and treated properly. The clinical manifestations of IOTB are varied, and the duration of treatment is unclear. This study describes the clinical characteristics and outcomes of patients with IOTB and compares the duration of antituberculosis therapy (ATT) and steroid use.</p></div><div><h3>Method</h3><p>An 8-year retrospective study of IOTB patients in an endemic area of a tertiary hospital in Thailand. All patients had a complete treatment of ATT at least for 6 months.</p></div><div><h3>Results</h3><p>Forty-three patients with 57 eyes and a mean age of 43.72 years were included. Panuveitis (38.6 %), retinal phlebitis (31.6 %), and posterior uveitis (15.8 %) were common clinical characteristics. A significant difference between initial and final best corrected visual acuity (BCVA) after ATT in 6 months for therapy and at least 9 months for therapy was observed (<em>p</em> = 0.004, 0.003, respectively). Ninety point nine percent of patients who received ATT for 9 months achieved a successful treatment outcome, while 66.7 % of patients who received ATT for 6 months did <em>(p</em> = 0.056). Patients who received systemic and/or regional corticosteroids therapy during treatment had a higher rate of treatment failure (<em>p</em> < 0.001).</p></div><div><h3>Conclusion</h3><p>IOTB<!--> <!-->had a variety of clinical manifestations, including nongranulomatous inflammation. Patients who completed treatment with<!--> <!-->ATT for at least 6 months improved their final<!--> <!-->BCVA. There was no difference in treatment outcomes regarding the duration of treatment. Combined treatment with systemic and/or regional corticosteroids was significantly associated with failed treatment outcomes.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579424000263/pdfft?md5=7752dce106669146d6adfb42a51479a6&pid=1-s2.0-S2405579424000263-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Characteristics and outcomes of the duration of treatment with adjunctive corticosteroids in intraocular tuberculosis\",\"authors\":\"Yaninsiri Ngathaweesuk , Sitrapa Janthayanont , Narumon Keorochana\",\"doi\":\"10.1016/j.jctube.2024.100439\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Intraocular tuberculosis (IOTB) is a common site of extrapulmonary tuberculosis and a main cause of infectious uveitis. It can result in severe visual morbidity if not recognized and treated properly. The clinical manifestations of IOTB are varied, and the duration of treatment is unclear. This study describes the clinical characteristics and outcomes of patients with IOTB and compares the duration of antituberculosis therapy (ATT) and steroid use.</p></div><div><h3>Method</h3><p>An 8-year retrospective study of IOTB patients in an endemic area of a tertiary hospital in Thailand. All patients had a complete treatment of ATT at least for 6 months.</p></div><div><h3>Results</h3><p>Forty-three patients with 57 eyes and a mean age of 43.72 years were included. Panuveitis (38.6 %), retinal phlebitis (31.6 %), and posterior uveitis (15.8 %) were common clinical characteristics. A significant difference between initial and final best corrected visual acuity (BCVA) after ATT in 6 months for therapy and at least 9 months for therapy was observed (<em>p</em> = 0.004, 0.003, respectively). Ninety point nine percent of patients who received ATT for 9 months achieved a successful treatment outcome, while 66.7 % of patients who received ATT for 6 months did <em>(p</em> = 0.056). Patients who received systemic and/or regional corticosteroids therapy during treatment had a higher rate of treatment failure (<em>p</em> < 0.001).</p></div><div><h3>Conclusion</h3><p>IOTB<!--> <!-->had a variety of clinical manifestations, including nongranulomatous inflammation. Patients who completed treatment with<!--> <!-->ATT for at least 6 months improved their final<!--> <!-->BCVA. There was no difference in treatment outcomes regarding the duration of treatment. 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引用次数: 0
摘要
导言眼内结核(IOTB)是肺外结核的常见部位,也是传染性葡萄膜炎的主要病因。如果认识不足、治疗不当,可导致严重的视力病变。IOTB 的临床表现多种多样,治疗时间也不明确。本研究描述了 IOTB 患者的临床特征和治疗结果,并比较了抗结核治疗(ATT)和类固醇使用的持续时间。结果共纳入 43 名患者,57 只眼睛,平均年龄 43.72 岁。泛发性葡萄膜炎(38.6%)、视网膜静脉炎(31.6%)和后葡萄膜炎(15.8%)是常见的临床特征。在 ATT 治疗 6 个月和至少 9 个月后,观察到初始视力和最终最佳矫正视力(BCVA)之间存在明显差异(p = 0.004,0.003,分别为 0.004 和 0.003)。在接受 ATT 治疗 9 个月的患者中,90.9% 的患者获得了成功的治疗结果,而在接受 ATT 治疗 6 个月的患者中,66.7% 的患者获得了成功的治疗结果(p = 0.056)。结论IOTB有多种临床表现,包括非肉芽肿性炎症。完成 ATT 治疗至少 6 个月的患者的最终 BCVA 均有所改善。在治疗持续时间方面,治疗效果没有差异。全身性和/或区域性皮质类固醇的联合治疗与失败的治疗结果有显著相关性。
Characteristics and outcomes of the duration of treatment with adjunctive corticosteroids in intraocular tuberculosis
Introduction
Intraocular tuberculosis (IOTB) is a common site of extrapulmonary tuberculosis and a main cause of infectious uveitis. It can result in severe visual morbidity if not recognized and treated properly. The clinical manifestations of IOTB are varied, and the duration of treatment is unclear. This study describes the clinical characteristics and outcomes of patients with IOTB and compares the duration of antituberculosis therapy (ATT) and steroid use.
Method
An 8-year retrospective study of IOTB patients in an endemic area of a tertiary hospital in Thailand. All patients had a complete treatment of ATT at least for 6 months.
Results
Forty-three patients with 57 eyes and a mean age of 43.72 years were included. Panuveitis (38.6 %), retinal phlebitis (31.6 %), and posterior uveitis (15.8 %) were common clinical characteristics. A significant difference between initial and final best corrected visual acuity (BCVA) after ATT in 6 months for therapy and at least 9 months for therapy was observed (p = 0.004, 0.003, respectively). Ninety point nine percent of patients who received ATT for 9 months achieved a successful treatment outcome, while 66.7 % of patients who received ATT for 6 months did (p = 0.056). Patients who received systemic and/or regional corticosteroids therapy during treatment had a higher rate of treatment failure (p < 0.001).
Conclusion
IOTB had a variety of clinical manifestations, including nongranulomatous inflammation. Patients who completed treatment with ATT for at least 6 months improved their final BCVA. There was no difference in treatment outcomes regarding the duration of treatment. Combined treatment with systemic and/or regional corticosteroids was significantly associated with failed treatment outcomes.
期刊介绍:
Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.