Kee Ae Ra, Gonzalez-Lopez Julio J, Al-Hity Aws, Gupta Bhaskar, Lee Cecilia S, Gunasekeran Dinesh Visva, Jayabalan Nirmal, Grant Robert, Kon Onn Min, Gupta Vishali, Westcott Mark, Pavesio Carlos, Agrawal Rupesh
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK.
Surv Ophthalmol. 2016 Sep-Oct;61(5):628-53. doi: 10.1016/j.survophthal.2016.03.001. Epub 2016 Mar 10.
Intraocular tuberculosis remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyze the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular tuberculosis and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1,917 patients. Nonrecurrence of inflammation was observed in pooled estimate of 84% of ATT-treated patients (95% CI 79-89). There was minimal difference in the outcome between patients treated with ATT alone (85% successful outcome; 95% CI 25-100) and those with concomitant systemic corticosteroid (82%; 95% CI 73-90). The use of ATT may be of benefit to patients with suspected intraocular tuberculosis; however, this conclusion is limited by the lack of control group analysis and standardized recruitment and treatment protocols. We propose further prospective studies to better establish the efficacy of ATT and ascertain the factors associated with favorable treatment outcomes.
眼内结核对于眼科医生和肺科医生而言，仍然是一个诊断和治疗难题。我们分析了抗结核治疗（ATT）在眼内结核患者中的疗效和安全性，以及与良好预后相关的因素。本综述纳入了28项研究，共1917例患者。在接受ATT治疗的患者汇总估计中，84%观察到炎症未复发（95%可信区间79 - 89）。单独接受ATT治疗的患者（85%治疗成功；95%可信区间25 - 100）与同时接受全身皮质类固醇治疗的患者（82%；95%可信区间73 - 90）之间的治疗结果差异极小。使用ATT可能对疑似眼内结核患者有益；然而，这一结论因缺乏对照组分析以及标准化的招募和治疗方案而受到限制。我们建议进一步开展前瞻性研究，以更好地确定ATT的疗效，并确定与良好治疗结果相关的因素。
