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Presumed tuberculosis-related scleritis
  1. Maite Sainz de La Maza1,
  2. Ines Hernanz2,
  3. Aina Moll-Udina1,
  4. Marina Mesquida3,
  5. Alfredo Adan1,
  6. Jose Antonio Martinez4,
  7. Gerard Espinosa5,
  8. Víctor Llorenç1
  1. 1Ophthalmology, Hospital Clinic de Barcelona, Barcelona, Spain
  2. 2Ophthalmology, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
  3. 3Ophthalmology, Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
  4. 4Department of Infectious Diseases, Hospital Clinic de Barcelona, Barcelona, Spain
  5. 5Autoimmune Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
  1. Correspondence to Dr Maite Sainz de La Maza, Ophthalmology, Hospital Clinic de Barcelona, Barcelona 08036, Spain; sainzdelamazamaite{at}gmail.com

Abstract

Aims To evaluate the clinical characteristics and therapeutic outcome of patients with recurrent scleritis of unknown demonstrable aetiology and positive QuantiFERON-TB Gold In-Tube test (QFT).

Methods Retrospective chart review of the demographic, clinical, laboratory and therapeutic outcome data of 15 patients. Clinical characteristics as well as remission rate after standard antituberculous therapy (ATT) were assessed.

Results There were 9 men and 6 women with a mean age of 48.9 years (range, 32–73). Scleritis was diffuse in 10 patients (66.6%) and nodular in 5 patients (33.3%), 1 of them with concomitant posterior scleritis. It was bilateral in 7 patients (46.6%) and recurrent in all of them. Scleritis appeared after prior uveitis (10 patients, 66.6%) and/or with concomitant uveitis (5 patients, 33.3%) or peripheral keratitis (5 patients, 33.3%). Previous ocular surgery was found in 7 patients (46.6%). Previous extraocular tuberculosis (TB) infection or previous TB contact was detected in 11 patients (73.3%). No radiologic findings of active extraocular TB were detected. ATT was used in 15 patients, sometimes with the addition of systemic corticosteroids (5 patients) and methotrexate (1 patient); 14 patients achieved complete remission (93.3%).

Conclusion Presumed TB-related scleritis may appear in recurrent scleritis of unknown origin and positive QFT. It may occur after prior uveitis and/or concomitantly with uveitis or peripheral keratitis, and it may be triggered by previous ocular surgery. No patients had evidence of concurrent active extraocular infection, although many had previous TB infection or TB contact. ATT was effective, sometimes with the addition of systemic corticosteroids and methotrexate.

  • infection
  • inflammation
  • sclera and episclera

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data relevant to the study are included in the article.

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Footnotes

  • Twitter @gerardespinosa5

  • Contributors MSdLM and VL planned the study, drafted, read and approved submission of this version for publication. IH, AM-U and MM collected and analysed the data. AA, JAM and GE supervised the study and revised the draft. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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