Abstract
Purpose
To compare the time to resolution of perivascular infiltrates in tubercular retinal vasculitis (TRV) between anti-tubercular therapy (ATT) alone, and in combination with systemic corticosteroids.
Methods
Observational retrospective cohort study in a tertiary eye centre in eastern India. Patients with TRV who were treated with anti-tubercular therapy (ATT) alone (Group A), or in combination with systemic corticosteroids (Group B) were included in the study. Eyes with additional inflammatory signs (cystoid macular oedema, vitritis ≥2+, optic disc oedema) were excluded. Resolution was defined as complete disappearance of perivascular infiltrates on seven-field fundus photographs. Descriptive statistics were used for demographic data. A linear mixed effects model was applied to adjust for intereye correlations, in patients with bilateral disease. The primary outcome measure was time to resolution of perivascular infiltrates. Secondary outcome measure was need for laser or surgical intervention for management of complications of TRV.
Results
Fifty eyes of 39 patients (Group A 21/18 and Group B 29/21) were included. Both groups had similar demographics and severity of vasculitis. All patients had complete resolution of TRV. On adjusting for intereye correlation, the mean difference in time to resolution between the two groups (Group A, 3.24 [95% CI 2.69–3.77] months, and Group B, 4.76 [95% CI 3.52–5.99] months) was not statistically significant (0.96 weeks [−0.52 to 2.45] p = 0.21). Vaso-occlusive complications and healing patterns were similar in both groups.
Conclusions
ATT alone, may be sufficient for resolution of perivascular infiltrates, in TRV without additional inflammatory signs.
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Acknowledgements
The study was supported by Hyderabad Eye Research Foundation. We also thank Krishna Gopal Panda and Aniruddha Banerjee for fundus photography, Bhawna Garg for most statistical analyses, Mohammed Hasnat Ali for performing statistical analysis for intereye corelation.
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AK: Data collection and analysis; revision of manuscript; final approval. VG: Data collection and analysis; revision of manuscript; final approval. AK: Data collection and analysis; revision of manuscript; final approval. SB: Conception of study; analysis; initial draft and revision of manuscript. All authors approved the submission.
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Kelgaonkar, A., Govindhari, V., Khalsa, A. et al. Anti-tubercular therapy alone for treatment of isolated tubercular retinal vasculitis. Eye 36, 1777–1782 (2022). https://doi.org/10.1038/s41433-021-01727-3
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DOI: https://doi.org/10.1038/s41433-021-01727-3
