Ocular tuberculosis with Mycobacterium tuberculosis DNA presence in ocular fluid: will post-COVID era bring a ... - Nature.com

Ocular tuberculosis (TB) diagnosis remains a challenge as it is mainly achieved by detection of coexistence active systemic TB, or as in many cases is presumptive, based on a positive tuberculin skin test or interferon-gamma release assay [1]. Testing to confirm the presence of Mycobacterium tuberculosis (Mtb) in the eye is not commonly performed. In a study by the Collaborative Ocular Tuberculosis Study (COTS) group involving 962 patients from 25 centres, polymerase chain reaction (PCR) testing using ocular fluid samples was performed only in 59 patients (6.1%) [2]. While only a small subset of patients underwent these tests, a positive result (33 out of 59 patients, 55.9%) would definitely lead to the decision to start anti-tubercular treatment (ATT) [2].

We analysed data from all uveitis patients who underwent PCR including Mtb in the panel before or shortly during the pandemic (January 2014 - December 2020) and after the pandemic (January 2022 - January 2024) in our centre. The data was part of the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) [5] approved by the IRB (KET-850/UN2.F1/ETIK/PPM.00.02/2022). Before the pandemic, ocular fluid testing was performed using uniplex PCR in selected patients. After the pandemic, PCR tests were performed using a multiplex panel of pathogens, and the cost was waived.

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Fig. 1: Trends of TB in Indonesia over time.

Data availability

The cohort data analysed during the current study are available from the corresponding author upon reasonable request. Data on the incidence of TB in Indonesia were retrieved from The World Bank Group under a CC BY-4.0 license.

References

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Funding

Funding

This study was supported by Riset Inovatif Produktif - Lembaga Pengelola Dana Pendidikan (RISPRO LPDP) [grant number RISPRO/KI/B1/KOM/5/15219/4/2020]. The funding source was not involved in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, University of Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia

    Ikhwanuliman Putera, Erica Widodo, Mei Riasanti, Muhammad Zakiy Waliyuddin, Ratna Sitompul, Lukman Edwar, Made Susiyanti, Yulia Aziza & Rina La Distia Nora

  2. Laboratory Medical Immunology, Department of Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Ikhwanuliman Putera, P. Martin van Hagen & Rina La Distia Nora

  3. Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Ikhwanuliman Putera

  4. Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Ikhwanuliman Putera & P. Martin van Hagen

  5. Department of Microbiology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia

    Andi Yasmon

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  1. Ikhwanuliman Putera
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  2. Erica Widodo
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  8. Yulia Aziza
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  11. Rina La Distia Nora
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Contributions

RLDN and IP contributed to the study conception and design. Material preparation, acquisition of data and analysis were performed by IP, EW, and RLDN. Clinical data were interpreted by IP, RS, LE, MS, YA, and RLDN. PCR results were interpreted by MR, MZW, and AY. Final data interpretation and analysis were performed by all authors. The first draft of the manuscript was written by IP. All authors reviewed, revised, and approved all versions of the article before submission.

Corresponding author

Correspondence to Rina La Distia Nora.

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Putera, I., Widodo, E., Riasanti, M. et al. Ocular tuberculosis with Mycobacterium tuberculosis DNA presence in ocular fluid: will post-COVID era bring a difference?. Eye (2024). https://doi.org/10.1038/s41433-024-03200-3

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  • DOI: https://doi.org/10.1038/s41433-024-03200-3

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