Abstract：
To evaluate the diagnostic value of QuantiFERON Gold (QFT-G) testing for ocular inflammation in a low prevalence tuberculosis (TB) area.
Diagnostic utility analysis.
A review was performed for all uveitis patients who underwent QFT-G testing at the University of Colorado Eye Center from 2009 to 2022. Records were reviewed to assess QFT-G positivity rate and to identify which patients were tested for diagnostic purposes, defined as meeting the Standardization of Uveitis Nomenclature (SUN) criteria for tubercular uveitis (TBU): anterior uveitis with iris nodules, serpiginous-like choroiditis, choroidal nodule resembling a tuberculoma, multifocal choroiditis, or occlusive retinal vasculitis.
A total of 388 patients with uveitis underwent QFT-G testing, of which 17 (4.38%) were positive. Only one (5.88%) patient had true TBU with anterior uveitis with iris nodules. The remaining 16 (94.1%) patients did not meet SUN criteria for TBU and were incidentally found to be QFT-G positive during laboratory work-up prior to immunosuppression. The positive predictive value was 100% when QFT-G testing was performed in patients who met SUN criteria for TBU, whereas the positive predictive value was 0% for QFT-G testing performed in patients who did not meet SUN criteria for TBU.
In low prevalence areas, the majority of QFT-G positive tests in uveitis patients are coincidental and unrelated to their uveitic disease process. The diagnostic value of a TB test is likely to be minimal unless the SUN clinical criteria for tubercular uveitis are met.
Diagnostic utility analysis.
A review was performed for all uveitis patients who underwent QFT-G testing at the University of Colorado Eye Center from 2009 to 2022. Records were reviewed to assess QFT-G positivity rate and to identify which patients were tested for diagnostic purposes, defined as meeting the Standardization of Uveitis Nomenclature (SUN) criteria for tubercular uveitis (TBU): anterior uveitis with iris nodules, serpiginous-like choroiditis, choroidal nodule resembling a tuberculoma, multifocal choroiditis, or occlusive retinal vasculitis.
A total of 388 patients with uveitis underwent QFT-G testing, of which 17 (4.38%) were positive. Only one (5.88%) patient had true TBU with anterior uveitis with iris nodules. The remaining 16 (94.1%) patients did not meet SUN criteria for TBU and were incidentally found to be QFT-G positive during laboratory work-up prior to immunosuppression. The positive predictive value was 100% when QFT-G testing was performed in patients who met SUN criteria for TBU, whereas the positive predictive value was 0% for QFT-G testing performed in patients who did not meet SUN criteria for TBU.
In low prevalence areas, the majority of QFT-G positive tests in uveitis patients are coincidental and unrelated to their uveitic disease process. The diagnostic value of a TB test is likely to be minimal unless the SUN clinical criteria for tubercular uveitis are met.
摘要：
目的：评价QuantiFERON金（QFT-G）检测对低患病率结核病（TB）地区眼部炎症的诊断价值。
方法：诊断实用程序分析。
方法：对2009年至2022年在科罗拉多大学眼科中心接受QFT-G测试的所有葡萄膜炎患者进行了回顾。对记录进行审查，以评估QFT-G阳性率，并确定哪些患者进行了诊断测试。符合葡萄膜炎命名标准（SUN）标准的结核性葡萄膜炎（TBU）：虹膜结节的前葡萄膜炎，血清素样脉络膜炎,脉络膜结节类似结核瘤，多灶性脉络膜炎,或者闭塞性视网膜血管炎.
结果：共有388例葡萄膜炎患者接受了QFT-G检测，其中17人（4.38%）为阳性。仅有1例（5.88%）患者患有伴有虹膜结节的前葡萄膜炎的真正TBU。其余16例（94.1％）患者不符合TBU的SUN标准，并且在免疫抑制之前的实验室检查中偶然发现QFT-G阳性。在符合TBUSUN标准的患者中进行QFT-G测试时，阳性预测值为100％，而在不符合TBUSUN标准的患者中进行QFT-G检测的阳性预测值为0%.
结论：在低患病率地区，葡萄膜炎患者的大多数QFT-G阳性测试是偶然的,与葡萄膜疾病过程无关.除非符合结核性葡萄膜炎的SUN临床标准，否则TB测试的诊断价值可能很小。
方法：诊断实用程序分析。
方法：对2009年至2022年在科罗拉多大学眼科中心接受QFT-G测试的所有葡萄膜炎患者进行了回顾。对记录进行审查，以评估QFT-G阳性率，并确定哪些患者进行了诊断测试。符合葡萄膜炎命名标准（SUN）标准的结核性葡萄膜炎（TBU）：虹膜结节的前葡萄膜炎，血清素样脉络膜炎,脉络膜结节类似结核瘤，多灶性脉络膜炎,或者闭塞性视网膜血管炎.
结果：共有388例葡萄膜炎患者接受了QFT-G检测，其中17人（4.38%）为阳性。仅有1例（5.88%）患者患有伴有虹膜结节的前葡萄膜炎的真正TBU。其余16例（94.1％）患者不符合TBU的SUN标准，并且在免疫抑制之前的实验室检查中偶然发现QFT-G阳性。在符合TBUSUN标准的患者中进行QFT-G测试时，阳性预测值为100％，而在不符合TBUSUN标准的患者中进行QFT-G检测的阳性预测值为0%.
结论：在低患病率地区，葡萄膜炎患者的大多数QFT-G阳性测试是偶然的,与葡萄膜疾病过程无关.除非符合结核性葡萄膜炎的SUN临床标准，否则TB测试的诊断价值可能很小。
