Filardo Thomas D, Andrzejewski Aryn, Croix Michael, Self Julie L, Fraimow Henry S, Munsiff Sonal S
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA.
Open Forum Infect Dis. 2024 Aug 22;11(9):ofae476. doi: 10.1093/ofid/ofae476. eCollection 2024 Sep.
Data regarding ocular tuberculosis (OTB) in the United States have not been previously reported. We evaluated trends of OTB compared with other extrapulmonary TB (EPTB).
We estimated the proportion of all EPTB cases (with or without concurrent pulmonary involvement) with OTB reported to the National Tuberculosis Surveillance System during 1993-2019. We compared demographics and clinical characteristics of people with OTB and other EPTB during 2010-2019. values were calculated by chi-square test for categorical variables and Kruskal-Wallis for continuous variables.
During 1993-2019, 1766 OTB cases were reported, representing 1.6% of 109 834 all EPTB cases: 200 (0.5% of 37 167) during 1993-1999, 395 (1.0% of 41 715) during 2000-2009, and 1171 (3.8% of 30 952) during 2010-2019. In contrast to persons with other EPTB, persons with OTB were older (median, 48 vs 44 years; < .01), more likely to be US-born (35% vs 28%; < .01), more likely to have diabetes (17% vs 13%; < .01), and less likely to have HIV (1% vs 8%; < .01). OTB was less likely to be laboratory confirmed (5% vs 75%; < .01), but patients were more likely to be tested by interferon gamma release assay (IGRA; 84% vs 56%; < .01) and to be IGRA positive (96% vs 80%; < .01).
Reported OTB increased during 1993-2019 despite decreasing TB, including EPTB; the largest increase occurred during 2010-2019. OTB was rarely laboratory confirmed and was primarily diagnosed in conjunction with IGRA results. More research is needed to understand the epidemiology of OTB to inform clinical and diagnostic practices.
此前美国尚未有关于眼部结核病（OTB）的数据报告。我们评估了OTB与其他肺外结核病（EPTB）相比的趋势。
我们估算了1993 - 2019年期间向国家结核病监测系统报告的所有EPTB病例（有或无并发肺部受累）中OTB病例的比例。我们比较了2010 - 2019年期间OTB患者和其他EPTB患者的人口统计学特征和临床特征。分类变量采用卡方检验计算 值，连续变量采用Kruskal - Wallis检验计算 值。
1993 - 2019年期间，共报告了1766例OTB病例，占109834例所有EPTB病例的1.6%：1993 - 1999年期间为200例（占37167例的0.5%），2000 - 2009年期间为395例（占41715例的1.0%），2010 - 2019年期间为1171例（占30952例的3.8%）。与其他EPTB患者相比，OTB患者年龄更大（中位数分别为48岁和44岁； <.01），更有可能出生在美国（35%对28%； <.01），更有可能患有糖尿病（17%对13%； <.01），而感染HIV的可能性更小（1%对8%； <.01）。OTB经实验室确诊的可能性较小（5%对75%； <.01），但患者接受干扰素γ释放试验（IGRA）检测的可能性更大（84%对56%； <.01），且IGRA检测呈阳性的可能性更大（96%对80%； <.01）。
尽管包括EPTB在内的结核病发病率下降，但1993 - 2019年期间报告的OTB病例有所增加；最大增幅发生在2010 - 2019年期间。OTB很少通过实验室确诊，主要结合IGRA检测结果进行诊断。需要更多研究来了解OTB的流行病学情况，为临床和诊断实践提供依据。
