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Agarwal A, Aggarwal K, Gupta V, Agrawal R, Nguyen QD. Advances in imaging and molecular diagnostics of ocular tuberculosis and selected observations from the Collaborative Ocular Tuberculosis Study (COTS). EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1555472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Aniruddha Agarwal
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Kanika Aggarwal
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Quan Dong Nguyen
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
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Agarwal A, Agrawal R, Gunasekaran DV, Raje D, Gupta B, Aggarwal K, Murthy SL, Westcott M, Chee SP, McCluskey P, Ling HS, Teoh S, Cimino L, Biswas J, Narain S, Agarwal M, Mahendradas P, Khairallah M, Jones N, Tugal-Tutkun I, Babu K, Basu S, Carreño E, Lee R, Al-Dhibi H, Bodaghi B, Invernizzi A, Goldstein DA, Herbort CP, Barisani-Asenbauer T, González-López JJ, Androudi S, Bansal R, Moharana B, Mahajan S, Esposti S, Tasiopoulou A, Nadarajah S, Agarwal M, Abraham S, Vala R, Singh R, Sharma A, Sharma K, Zierhut M, Kon OM, Cunningham E, Nguyen QD, Pavesio C, Gupta V. The Collaborative Ocular Tuberculosis Study (COTS)-1 Report 3: Polymerase Chain Reaction in the Diagnosis and Management of Tubercular Uveitis: Global Trends. Ocul Immunol Inflamm 2017; 27:465-473. [PMID: 29261089 DOI: 10.1080/09273948.2017.1406529] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.
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Affiliation(s)
- Aniruddha Agarwal
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Rupesh Agrawal
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore, Singapore.,c Moorfields Eye Hospital , NHS Foundation Trust , London , UK.,d Department of Ophthalmology , Yong Loo Lin School of Medicine, National University of Singapore , Singapore.,e Singapore Eye Research Institute , Singapore , Singapore
| | - Dinesh Visva Gunasekaran
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore, Singapore.,c Moorfields Eye Hospital , NHS Foundation Trust , London , UK.,d Department of Ophthalmology , Yong Loo Lin School of Medicine, National University of Singapore , Singapore
| | | | - Bhaskar Gupta
- g Royal Berkshire Hospital , NHS Foundation Trust , Reading , UK
| | - Kanika Aggarwal
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Somasheila L Murthy
- h Tej Kohli Cornea Institute, LV Prasad Eye Institute , Kallam Anji Reddy Campus , Hyderabad , India
| | - Mark Westcott
- c Moorfields Eye Hospital , NHS Foundation Trust , London , UK
| | - Soon Phaik Chee
- d Department of Ophthalmology , Yong Loo Lin School of Medicine, National University of Singapore , Singapore.,e Singapore Eye Research Institute , Singapore , Singapore.,i Singapore National Eye Centre , Singapore, Singapore.,j Duke-NUS Medical School , Singapore , Singapore
| | - Peter McCluskey
- k Department of Clinical Ophthalmology & Eye Health , Central Clinical School, Save Sight Institute, The University of Sydney , Sydney , Australia
| | - Ho Su Ling
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore, Singapore
| | - Stephen Teoh
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore, Singapore
| | - Luca Cimino
- l Ocular Immunology Unit, Department of Ophthalmology Arcispedale-IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia , Italy
| | | | | | - Manisha Agarwal
- o Dr Shroff's Charity Eye Hospital Daryaganj , New Delhi , India
| | | | - Moncef Khairallah
- q Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir , Tunisia
| | | | - Ilknur Tugal-Tutkun
- s Istanbul Faculty ofMedicine, Department of Ophthalmology , Istanbul University , Istanbul , Turkey
| | - Kalpana Babu
- t Department of Ophthalmology, Prabha Eye Clinic & Research centre , Vittala International Institute of Ophthalmology , Bangalore , India
| | | | | | | | - Hassan Al-Dhibi
- w King Khaled Eye Specialist Hospital , Riyadh , Kingdom of Saudi Arabia
| | - Bahram Bodaghi
- x DHU SightRestore , University of Pierre andMarie Curie , Paris , France
| | - Alessandro Invernizzi
- y Eye Clinic, Department of Biomedical and Clinical Science "L. Sacco" , Luigi Sacco Hospital, University of Milan , Milan , Italy
| | - Debra A Goldstein
- z Feinberg School of Medicine, Department of Ophthalmology , Northwestern University , Chicago , Illinois , USA
| | - Carl P Herbort
- aa Centre for Ophthalmic Specialised Care & University of Lausanne , Lausanne , Switzerland
| | - Talin Barisani-Asenbauer
- ab Laura Bassi Centre of Expertise Ocuvac, Center for Pathophysiology, Immunology and Infectiology , Medical University of Vienna , Vienna , Austria
| | | | - Sofia Androudi
- ad Department of Ophthalmology , University of Thessaly , Volos , Greece
| | - Reema Bansal
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Bruttendu Moharana
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Sarakshi Mahajan
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Simona Esposti
- c Moorfields Eye Hospital , NHS Foundation Trust , London , UK
| | | | | | | | | | - Ruchi Vala
- p Narayana Nethralaya , Bangalore , India
| | - Ramandeep Singh
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
| | - Aman Sharma
- ae Department of Rheumatology , PGIMER , Chandigarh, India
| | - Kusum Sharma
- af Department ofMicrobiology , PGIMER , Chandigarh, India
| | - Manfred Zierhut
- ag Centre of Ophthalmology, University of Tuebingen , Tuebingen , Germany
| | - Onn Min Kon
- ah Chest and Allergy Clinic, St Mary's Hospital , Imperial College HealthcareNHS Trust , London , UK
| | - Emmett Cunningham
- ai Francis I. Proctor Foundation for Research in Ophthalmology , University of California , San Francisco , USA
| | - Quan Dong Nguyen
- aj Byers Eye Institute , Stanford University , Palo Alto , CA , USA
| | - Carlos Pavesio
- c Moorfields Eye Hospital , NHS Foundation Trust , London , UK
| | - Vishali Gupta
- a Advanced Eye Centre , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India
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Biswas J, Kazi MS, Agarwal VA, Alam MS, Therese KL. Polymerase chain reaction for Mycobacterium tuberculosis DNA detection from ocular fluids in patients with various types of choroiditis in a referral eye center in India. Indian J Ophthalmol 2017; 64:904-907. [PMID: 28112131 PMCID: PMC5322705 DOI: 10.4103/0301-4738.198857] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aims: The aim of this study was to detect Mycobacterium tuberculosis (MTB) DNA with polymerase chain reaction (PCR) in aqueous or vitreous samples of patients suffering from choroiditis presumed to be infectious origin. Settings and Design: Hospital-based, retrospective case–control study. Subjects and Methods: In all, forty eyes of forty patients with choroiditis divided into two groups – Group A (serpiginous-like choroiditis, ampiginous choroiditis, multifocal choroiditis) and Group B (choroidal abscess, miliary tuberculosis (TB), choroidal tubercle) were analyzed retrospectively. In 27 controls (patients without uveitis undergoing phacoemulsification), anterior chamber aspirate was done and sample subjected to real-time PCR. Patients underwent nested PCR for MTB using IS6110 and MPB64 primers from aqueous (n = 39) or vitreous (n = 1). All patients underwent detailed ophthalmological examination by slit-lamp biomicroscopy, fundus examination by indirect ophthalmoscopy, and fundus photograph and fundus fluorescein angiography if required. Statistical Analysis: Positive results of PCR for MTB within the group and between two groups were statistically analyzed using Chi-square test. Results: There were 25 males and 15 females. Mean age at presentation was 34.66 years (range, 14–62). PCR positivity rates were 41.3% (n = 12/29) and 81.82% (n = 9/11) in Groups A and B, respectively. No controls had PCR-positive result. Comparison of PCR positivity rates showed statistically significant difference between Groups A and B (P = 0.028). Systemic TB was detected in 57.14% (n = 12/21) of all PCR-positive cases (Group A - 33.3%, n = 4/12; Group B - 88.9%, n = 8/9). Systemic antitubercular treatment (ATT) for 9 months and oral steroids were successful in resolution of choroiditis in all PCR-positive patients (n = 21) without disease recurrence. Conclusions: Eyes with choroiditis of suspected/presumed tubercular origin should be subjected to PCR for diagnosis of TB and subjected to ATT for prevention of recurrences.
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Affiliation(s)
- Jyotirmay Biswas
- Department of Uveitis, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Mohmmad Salman Kazi
- Vitreoretinal Fellow, Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India
| | | | - Md Shahid Alam
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - K Lily Therese
- L & T Microbiology Research Centre, Kamalnayan Bajaj Institute for Research in Vision and Ophthalmology, Vision Research Foundation, Chennai, Tamil Nadu, India
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