scholarly journals Intraocular Tuberculosis: A Challenging Case Mimicking Wet Age-Related Macular Degeneration

2021 ◽  
pp. 519-524
Author(s):  
Emanuela Interlandi ◽  
Francesco Pellegrini ◽  
Carlos Pavesio ◽  
Marco De Luca ◽  
Rocco De Marco ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Skin Testing ◽  
Chinese Patient ◽  
Age Related Macular Degeneration ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Delayed Treatment ◽  
Age Related ◽  
Release Assay ◽  
Systemic Symptoms

An otherwise healthy 72-year-old Chinese patient diagnosed with exudative age-related macular degeneration and decreased vision in left eye was fully investigated. The retrospective analysis of past multimodal imaging revealed bilateral severe choroidal neovascularization and choroiditis associated with a positive tuberculin skin testing and interferon-gamma release assay (QuantiFERON-TB Gold – Cellestis<sup>®</sup>, Chadstone, VIC, Australia) suggestive of latent ocular tuberculosis. The variable presentation and tests’ results interpretation represent the greatest limitations in understanding and treating intraocular TB (IOTB). This may present without any other systemic symptoms, the intraocular tissues are of limited access to biopsies and other tests, including imaging and immunological tests, are of relative value. This case highlights how variable may be the presentation of IOTB, which can be easily misdiagnosed leading to a delayed treatment and worse prognosis.

scholarly journals Tuberculin Skin Testing and Treatment Modulates Interferon-Gamma Release Assay Results for Latent Tuberculosis in Migrants

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e97366 ◽  
Author(s):  
Matthew K. O'Shea ◽  
Thomas E. Fletcher ◽  
Nicholas J. Beeching ◽  
Martin Dedicoat ◽  
David Spence ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Skin Testing ◽  
Latent Tuberculosis ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay

scholarly journals Estimating excess visual loss in people with neovascular age-related macular degeneration during the COVID-19 pandemic

2020 ◽  
Author(s):  
Darren S Thomas ◽  
Alasdair Warwick ◽  
Abraham Olvera-Barrios ◽  
Catherine Egan ◽  
Roy Schwartz ◽  
...  
Keyword(s):  
Simulation Model ◽  
Macular Degeneration ◽  
National Level ◽  
Treatment Delay ◽  
Age Related Macular Degeneration ◽  
Delayed Treatment ◽  
Visual Outcomes ◽  
Age Related ◽  
One Year ◽  
The Impact

Objectives: To report the reduction in new neovascular age-related macular degeneration (nAMD) referrals during the COVID-19 pandemic and estimate the impact of delayed treatment on visual outcomes at one year. Design: Retrospective clinical audit and simulation model. Setting: Multiple UK NHS ophthalmology centres. Participants: Data on the reduction in new nAMD referrals was obtained from four NHS Trusts in England comparing April 2020 to April 2019. To estimate the potential impact on one-year visual outcomes, a stratified bootstrap simulation model was developed drawing on an electronic medical records dataset of 20,825 nAMD eyes from 27 NHS Trusts. Main outcome measures: Simulated mean visual acuity and proportions of eyes with vision ≤6/60, ≤6/24 and ≥6/12 at one year under four hypothetical scenarios: no treatment delay, 3, 6 and 9-month treatment delays. Estimated additional number of eyes with vision ≤6/60 at one year nationally. Results: The number of nAMD referrals at four major eye treatment hospital groups based in England dropped on average by 72% (range 65 to 87%) in April 2020 compared to April 2019. Simulated one-year visual outcomes for 1000 nAMD eyes with a 3-month treatment delay suggested an increase in the proportion of eyes with vision ≤6/60 from 15.5% (13.2 to 17.9) to 23.3% (20.7 to25.9), and a decrease in the proportion of eyes with vision ≥6/12 (driving vision) from 35.1% (32.1 to 38.1) to 26.4% (23.8 to29.2). Outcomes worsened incrementally with longer modelled delays. Assuming nAMD referrals are reduced to this level at the national level for only one month, these simulated results suggest an additional 186-365 eyes with vision ≤6/60 at one-year with even a short treatment delay. Conclusions: We report a large decrease in nAMD referrals during the first month of COVID-19 lockdown and provide an important public health message regarding the risk of delayed treatment. As a conservative estimate, a treatment delay of 3 months could lead to a >50% relative increase in the number of eyes with vision ≤6/60 and 25% relative decrease in the number of eyes with driving vision at one year.

Absence of interferon-gamma release assay conversion following tuberculin skin testing

2011 ◽  
Vol 15 (6) ◽  
pp. 767-769 ◽  
Author(s):  
N. Ritz ◽  
C. Yau ◽  
T. G. Connell ◽  
M. Tebruegge ◽  
D. Leslie ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Skin Testing ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay

scholarly journals Interferon Gamma Release Assay versus Tuberculin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0154803 ◽  
Author(s):  
Sahal Al Hajoj ◽  
Bright Varghese ◽  
Alria Datijan ◽  
Mohammed Shoukri ◽  
Ali Alzahrani ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Healthcare Workers ◽  
Skin Testing ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay ◽  
Diverse Origin

scholarly journals The influence of delayed treatment due to COVID-19 on patients with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

2021 ◽  
Vol 12 ◽  
pp. 204062232110263
Author(s):  
Xinyu Zhao ◽  
Lihui Meng ◽  
Mingyue Luo ◽  
Weihong Yu ◽  
Hanyi Min ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Visual Function ◽  
Polypoidal Choroidal Vasculopathy ◽  
Age Related Macular Degeneration ◽  
College Hospital ◽  
Delayed Treatment ◽  
Medical College ◽  
Age Related ◽  
The Impact ◽  
Choroidal Vasculopathy

Purpose: To explore the impact of coronavirus disease 2019 (COVID-19) on the prognosis of patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV), and share the experience in managing them during pandemics. Method: This is a retrospective study of nAMD and PCV patients treated at Peking Union Medical College Hospital from 31 December 2019 to 1 August 2020. Baseline demographic and clinical characteristics, best corrected visual acuity (BCVA), optical coherence tomography (OCT) features, duration of delayed treatment and number of anti-vascular endothelial growth factor (VEGF) injections were analyzed. Results: A total of 130 nAMD patients (155 eyes) and 76 PCV patients (89 eyes) were identified. Compared to the conditions before COVID-19, the BCVA of delayed cases decreased significantly, and the proportion of patients presenting with sub-macular scar was significantly greater in the delayed treatment group ( p < 0.05). The BCVA of non-delayed cases remained stable, with the percentage of patients with disease activity sub-retinal fluid and hemorrhage at the fovea decreasing significantly ( p < 0.05). The stable cases who did not require anti-VEGF treatment had significantly worse baseline and final BCVA, these patients were likely to be chronic and ‘burnt out’ cases with significantly worse anatomical structures ( p < 0.05). Conclusions: The delayed cases due to the pandemic suffered compromised visual function and a higher rate of sub-macular scar formation, while the visual function of non-delayed cases remained stable with favorable anatomical outcomes, suggesting the importance of regular follow-up for nAMD and PCV patients. Besides, effective measures of hospitals during pandemics are crucial to provide timely treatment for chronic disease.

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