M Suo, M K Kenworthy, J Richards, M L Tay-Kearney, H Farah, R Perera
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引用次数: 0
摘要
目的描述西澳大利亚州(WA)眼结核的诊断、管理和治疗结果。设计对2007年至2018年西澳大利亚州的眼结核病例进行回顾性分析,完成抗结核治疗(ATT)后至少随访2年。在治疗反应分析中排除了 10 名患者;34 名患者符合纳入标准,其中 97.1% 出生于海外。没有患者出现眼外结核症状。胸部 X 光检查显示,11.7% 的患者(4 人)曾患肺结核。所有患者均接受了三种或四种 ATT 药物治疗。最常见的眼结核表现是视网膜血管炎(23.5%)。66.7% 的患者(22 人)在 ATT 治疗后眼部炎症完全消退,21.2% 的患者(7 人)眼部炎症减轻,仅需局部类固醇治疗。治疗失败的比例为 12.1%(4 例)。45.6%的患者出现副作用,其中胃肠道症状最为常见(27.2%)。我们的研究强调了在低流行率环境中诊断肺结核眼病所面临的挑战,以及葡萄膜炎和肺结核亚专科医生之间合作的重要性。
SETTINGThis was a retrospective chart review in Western Australia, Australia.OBJECTIVETo describe the diagnosis, management, and treatment outcomes of ocular TB in Western Australia (WA).DESIGNThis was a retrospective review of ocular TB cases in WA from 2007 to 2018 with a minimum 2-year follow-up upon completion of anti-TB therapy (ATT).RESULTSA total of 44 patients were referred to WA TB clinic. Ten were excluded from the analysis of treatment response; 34 met the inclusion criteria, of whom 97.1% were born overseas. No patients had symptomatic extraocular TB. Chest X-ray showed prior pulmonary TB in 11.7% of patients (n = 4). All patients were treated with three or four ATT drugs. The most common ocular TB manifestation was retinal vasculitis (23.5%). Full resolution of ocular inflammation following ATT occurred in 66.7% (n = 22), and reduced ocular inflammation requiring only topical steroid treatment was seen in 21.2% (n = 7). Treatment failure occurred in 12.1% (n = 4). Side effects were reported in 45.6% of patients, with gastrointestinal symptoms most common (27.2%).CONCLUSIONOur study is the first Australian study examining the management of ocular TB. Our study highlights the challenges in diagnosing TB ocular disease in a low-endemicity setting and the importance of the collaboration between uveitis and TB subspecialists..
期刊介绍:
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.