PDF(Pubmed)
Abstract：
Tuberculous uveitis (TBU) comprises a broad clinical spectrum of ocular manifestations, making its diagnosis challenging. Ophthalmologists usually require evidence from investigations to confirm or support a clinical diagnosis of TBU. Since direct isolation of the causative organism from ocular specimens has limitations owing to the small volume of the ocular specimens, resultant test positivities are low in yield. Immunodiagnostic tests, including the tuberculin skin test and interferon-gamma release assays (IGRAs), can help support a clinical diagnosis of TBU. Unlike the tuberculin skin test, IGRAs are in vitro tests that require a single visit and are not affected by prior Bacillus Calmette-Guerin vaccination. Currently, available IGRAs consist of different techniques and interpretation methods. Moreover, newer generations have been developed to improve the sensitivity and ability to detect active tuberculosis. This narrative review collates salient practice points as a reference for general ophthalmologists, such as evidence for the utilization of IGRAs in patients with suspected TBU, and summarizes basic knowledge and details of clinical applications of these tests in a clinical setting.
摘要：
结核性葡萄膜炎（TBU）包括广泛的临床眼部表现，使其诊断具有挑战性。眼科医生通常需要调查证据来确认或支持TBU的临床诊断。由于眼部标本体积小，直接从眼部标本中分离致病生物具有局限性，所得的测试阳性产率低。免疫诊断试验,包括结核菌素皮肤试验和干扰素-γ释放试验（IGRAs），可以帮助支持TBU的临床诊断。与结核菌素皮肤试验不同,IGRAs是需要单次访问的体外测试，并且不受先前卡介苗疫苗接种的影响。目前,可用的IGRA包括不同的技术和解释方法。此外，已经开发了新一代来提高检测活动性结核病的灵敏度和能力。这篇叙述性综述整理了突出的实践要点，作为普通眼科医生的参考，例如在疑似TBU的患者中使用IGRAs的证据，并总结了这些测试在临床环境中的基本知识和临床应用细节。
