کمک آزمایش IGRA در تشخیص سل چشمی: تجزیه و تحلیل نوع پنهان بیزی What does IGRA testing add to the diagnosis of ocular tuberculosis? A Bayesian latent class analysis

Methods This was a retrospective cohort study of patients seen at a large tertiary referral centre in the UK. Medical records of patients with presumed ocular TB were reviewed following approval by the Institutional Review Board (IRB). Patient records/information was anonymized and de-identified prior to analysis. This research was performed in adherence to the tenets of the declaration of Helsinki. Records of all the cases between 2005 to 2013 who had IGRA test and Mantoux test done were identified based on data from clinical laboratory at the centre. The clinical case definition of presumed ocular TB was based on broad non-specific clinical signs proposed by Gupta et al. in 2007. [4] Clinical phenotypes suggestive of TB include anterior uveitis (granulomatous, nongranulomatous), intermediate uveitis, posterior uveitis (choroidal tubercle or tuberculoma, subretinal abscess, serpiginous-like choroiditis), panuveitis, retinitis, retinal vasculitis and neuroretinitis. Patient data were retrieved and data collected included information on demographics, morphological diagnosis, investigations and therapeutic regimens. Patients at presentation were examined by the residents, along with senior uveitis specialists, for signs suggestive of ocular TB. All patients underwent comprehensive examination and investigations to exclude other infectious diseases and immunologic disorders, including chest radiograph. Angiotensin converting enzyme (ACE) and serology tests (HIV, syphilis, hepatitis B and C) were done, if deemed necessary. Patients with a clinical diagnosis of uveitis suggestive of TB in one or both eyes were included in the study. The QFT assay was performed as per manufacturer’s recommendations and results were interpreted as per the recommendations from manufacturer. [21] Patients with one of the ocular phenotypes mentioned above, and an elevated QFT or other features suggestive of ocular TB, were referred to a respiratory physician for initiation of ATT. All attempts were made to exclude cases with sarcoidosis using information from combination of biochemical test or radiological test.