Antituberculous Treatment Itself Might Prevent Visual Impairment in Presumed Tuberculosis-Related Uveitis

Purpose: To study the risk factors for visual loss in presumed tuberculosis-related uveitis (TRU). Methods: Retrospective observational cohort study of patients with TRU, either treated or not for tuberculosis, from January 2005 to January 2017. Clinical and demographic variables were recorded. Main outcome measure was a loss of visual acuity (VA) of ≥2 Snellen lines. A Generalized Estimation Equation was used to control between-eyes bias. A backward stepwise logistic regression multivariate analysis was conducted to elucidate independent risk factors. Results: One hundred and thirty-eight eyes from 82 patients were included. There were 45 males, median age at onset of uveitis was 40 years (Interquartile range, IQR 24). The median follow-up was 36 months (IQR 49.75) and 51 patients completed antituberculous treatment (ATT) for a mean of 9.37 months. In the multivariate model, ATT was the only independent protective factor for loss of VA (OR 0.13, 95% CI 0.04–0.37, p Conclusion: ATT itself may prevent visual loss in TRU.研究目的：探讨疑似结核相关性葡萄膜炎（tuberculosis-related uveitis, TRU）患者视力丧失的危险因素。 研究方法：本研究为回顾性观察队列研究，纳入2005年1月至2017年1月期间确诊为TRU的患者（无论是否接受抗结核治疗），记录其临床及人口统计学变量。主要结局指标为视力（visual acuity, VA）下降≥2行Snellen视力表刻度。采用广义估计方程（Generalized Estimation Equation）控制双眼间偏倚，并通过向后逐步逻辑回归多因素分析明确独立危险因素。 研究结果：本研究共纳入82例患者的138只患眼，其中男性45例；葡萄膜炎发病年龄中位数为40岁（四分位距interquartile range, IQR 24）。中位随访时间为36个月（四分位距IQR 49.75）；51例患者完成抗结核治疗（antituberculous treatment, ATT），平均治疗时长为9.37个月。多因素分析结果显示，抗结核治疗是视力丧失唯一的独立保护因素（比值比odds ratio, OR=0.13，95%置信区间confidence interval, CI：0.04~0.37，p）。 研究结论：抗结核治疗本身或可预防结核相关性葡萄膜炎患者的视力丧失。