Role of Interferon-Gamma Release Assay for the Diagnosis and Clinical Follow up in Ocular Tuberculosis. (7th February 2023)

• Record Type: Journal Article
• Authors: Fernández-Zamora, Yuslay; Finamor, Luciana Peixoto; Silva, Luci Meire P; S. Rodrigues, Denise; Casaroli-Marano, Ricardo P.; Muccioli, Cristina
• Is Part Of: Ocular immunology and inflammation. Volume 31:Number 2(2023)
• Page Start: 304
• Page End: 311
• Publication Date: 2023-02-07
• Subjects: Ocular tuberculosis -- interferon gamma release assay -- tuberculosis skin test -- diagnosis -- antitubercular treatment; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2022.2027459
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose: To assess the performance of interferon-gamma release assay (IGRA) associated with tuberculosis skin test (TST) for ocular tuberculosis (OTB) diagnosis and therapeutic decision making. Method: One hundred and ninety-one patients with ocular inflammation were prospectively followed-up. Patients with clinical signs highly suspected of OTB, TST≥10 mm, and/or IGRA≥0.35 IU/mL received antitubercular therapy (ATT). Sensitivity (Se), specificity (Sp), and area under the curve (AUC) were assessed. Results: Seventy-two (37.7%) patients received ATT for presumed OTB. Combining TST and IGRA had Se=89.6%, Sp=99.2%, and AUC (0.98) significantly higher compared to TST (0.85, Z=6.3, p<.001) or IGRA (0.95, Z=2.5, p=.01). Prior history of corticosteroids or immunosuppressant with concomitantly oral prednisone and baseline IGRA> 2.0 IU/mL was associated significantly with more recurrences in ATT patients (p=.01) . Conclusion: Considering TST and IGRA together was more effective in assessing OTB diagnosis. The real value of the IGRA test to predict recurrences needs further studies.