Prognostic factors for TB-associated uveitis in the Asia-Pacific Region: results of a modified Delphi survey

Soumyava Basu, Rina La Distia Nora, Narsing A. Rao, Xuejuan Jiang, Ahmad Fuady, International Ocular TB Study group

Research output: Contribution to journalArticle

Abstract

Background: Prognostic factors for TB-associated uveitis (TBU) remain mostly unknown, due to the challenges in interpretation of patient data. We present consensus list of prognostic factors for resolution of inflammation in TBU, by experts across the Asia-Pacific region. Methods: We applied a modified Delphi technique to generate consensus on prognostic factors influencing the resolution of inflammation in TB-associated: anterior uveitis (AU), retinal vasculitis (RV), and multifocal serpiginoid choroiditis (MSC). The initial questionnaire was developed through a face-to-face meeting. Sixteen uveitis experts from eleven Asia-Pacific countries were included. A single investigator circulated the questionnaire electronically and received the responses. Participants scored each item on 4-point Likert scale, in three successive rounds. After each round, a number of items were reduced based on response, and summary of responses was provided to participants. At the end of Round 3, items were considered significant if they: (1) achieved a median ≥2, and interquartile range ≤1, and (2) ≥75% of the respondents agreed on whether the item was a positive or negative prognostic factor. Results: Forty-two putative questionnaire items were considered. At the end of Rounds 3, 4, 9, and 8 items in AU, RV, and MSC, respectively, met significance criteria. These included duration of disease, previous corticosteroid/immunosuppressive therapy, co-existent HIV, disease-specific imaging features, multidrug resistant TB, and duration of anti-TB therapy. Conclusions: Consensus were achieved on multiple ocular and systemic factors that influence resolution of inflammation in TBU. These will form the groundwork for validation in prospective clinical trials.

Original languageEnglish
Pages (from-to)1693-1701
Number of pages9
JournalEye (Basingstoke)
Volume34
Issue number9
Early online date2 Jan 2020
DOIs
Publication statusPublished - 1 Sep 2020

Keywords

  • TBU
  • Delphi technique
  • intraocular inflammation

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    Basu, S., La Distia Nora, R., Rao, N. A., Jiang, X., Fuady, A., & International Ocular TB Study group (2020). Prognostic factors for TB-associated uveitis in the Asia-Pacific Region: results of a modified Delphi survey. Eye (Basingstoke), 34(9), 1693-1701. https://doi.org/10.1038/s41433-019-0743-1