Presumed ocular tuberculosis in a developed country: a descriptive retrospective analysis of patients from a tertiary health care centre in the United Kingdom

PurposeTo describe the clinical presentation of Tuberculosis uveitis (TBU) in a developed country (tertiary health Care Centre in The UK) and its association with the response to anti-TB treatment (ATT).MethodsA retrospective study, in which, we collected data on ocular TB from a tertiary referral center in a developed country from a total of 100 eyes of 56 patients. The collected data were analyzed from the perspective of visual acuity at the presentation and the last visit, clinical presentation, treatment started, and the need for immune suppressive therapy.ResultsPan uveitis was the most common clinical presentation (40%). All patients received ATT. Comparing mean baseline visual acuity 0.49 +/- 0.65 was slightly reduced to 0.45 +/- 0.72 (3 months after completing ATT), however, this difference was not statistically significant. The rate of treatment failure was 44%. Twenty-five patients needed additional immunosuppression (steroid alone or combined with immune suppressive therapy) 3 months after completing the ATT because of persistent inflammation.ConclusionTBU is still a diagnosis that needs to be considered and excluded in developed areas. Long-term Immunosuppressive medication may be needed for cases of TBU with significant intraocular inflammation either during or after ATT. Uveitis pattern and presence or absence of disc edema could predict the need for immunosuppression.