Putera Ikhwanuliman, Sifyana Ulifna Alfiya, Rombach Saskia M, Vingerling Johannes R, van Hagen P Martin, La Distia Nora Rina
Department of Ophthalmology, Faculty Of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands.
IJID Reg. 2025 Jul 18;16:100705. doi: 10.1016/j.ijregi.2025.100705. eCollection 2025 Sep.
Uveitis may lead to blindness if improperly treated, yet the data on blindness due to uveitis, particularly, in low-resource countries, remain limited. In high-tuberculosis (TB) burden countries such as Indonesia, active systemic TB is among the leading causes of infectious uveitis. The combined impact of blindness, uveitis, and TB presents a substantial health and socioeconomic burden. This study aimed to assess the current situation of uveitis referrals, particularly, on the proportion of uveitis with active systemic TB and the proportion of blindness in TB-related uveitis.
We retrospectively analyzed 1-year data from 164 newly referred patients with uveitis at a single tertiary eye Hospital in Indonesia.
Active systemic TB was diagnosed in approximately one in 10 patients with uveitis (16 of 164, 9.8%). At initial presentation, blindness in the worse-seeing eye was noted in 56.1% (92 of 164) of patients. The proportion of blindness was slightly higher in patients with uveitis with active systemic TB and those with no identifiable cause but positive Quantiferon-TB Gold Plus, compared with other uveitis cases, although not statistically significant (56.3%, 61.1%, and 51.3%, respectively; = 0.489). Most patients with uveitis with active systemic TB (14 of 16, 87.5%) sought medical attention due to ophthalmological symptoms.
Active TB case finding in patients with uveitis, especially in high-TB burden settings, is obligatory to prevent severe morbidity.
葡萄膜炎若治疗不当可能导致失明，但关于葡萄膜炎所致失明的数据，尤其是在资源匮乏国家的数据仍然有限。在印度尼西亚等高结核病负担国家，活动性全身性结核病是感染性葡萄膜炎的主要病因之一。失明、葡萄膜炎和结核病的综合影响带来了巨大的健康和社会经济负担。本研究旨在评估葡萄膜炎转诊的现状，特别是伴有活动性全身性结核病的葡萄膜炎比例以及结核病相关性葡萄膜炎中的失明比例。
我们回顾性分析了印度尼西亚一家三级眼科专科医院164例新转诊的葡萄膜炎患者的1年数据。
在约十分之一的葡萄膜炎患者中诊断出活动性全身性结核病（164例中的16例，9.8%）。初诊时，56.1%（164例中的92例）的患者视力较差的眼睛存在失明情况。与其他葡萄膜炎病例相比，伴有活动性全身性结核病的葡萄膜炎患者以及无明确病因但结核菌素皮肤试验金标加强版呈阳性的患者中的失明比例略高，尽管无统计学意义（分别为56.3%、61.1%和51.3%；P = 0.489）。大多数伴有活动性全身性结核病的葡萄膜炎患者（16例中的14例，87.5%）因眼科症状就医。
在葡萄膜炎患者中，尤其是在高结核病负担地区，开展活动性结核病筛查对于预防严重发病至关重要。
