Aims To assess the risk of uveitis relapse in ocular tuberculosis (OTB) following clinical inactivity, to analyse clinical factors associated with relapses and to describe the management strategies for relapses. Methods A retrospective study was conducted on a 10-year patient registry of patients with OTB diagnosed at Erasmus MC in Rotterdam, The Netherlands. Time-to-relapse of uveitis was evaluated with Kaplan-Meier curve and risk factors for relapses were analysed. Results 93 OTB cases were identified, of which 75 patients achieved clinical inactivity following treatment. The median time to achieve uveitis inactivity was 3.97 months. During a median follow-up of 20.7 months (Q1–Q3: 5.2–81.2) after clinical inactivity, uveitis relapse occurred in 25 of these 75 patients (33.3%). Patients who were considered poor treatment responders for their initial uveitis episode had a significantly higher risk of relapse after achieving clinical inactivity than good responders (adjusted HR=3.84, 95% CI: 1.28 to 11.51). 13 of the 25 relapsed patients experienced multiple uveitis relapse episodes, accounting for 78 eye-relapse episodes during the entire observation period. Over half (46 out of 78, 59.0%) of these episodes were anterior uveitis. A significant number of uveitis relapse episodes (31 episodes, 39.7%) were effectively managed with topical corticosteroids. Conclusions Our results suggest that approximately one-third of patients with OTB will experience relapse after achieving clinical inactivity. The initial disease course and poor response to treatment predict the likelihood of relapse in the long-term follow-up. Topical corticosteroids were particularly effective in relapse presenting as anterior uveitis. Data are available upon reasonable request.

中文翻译：

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眼结核复发：非流行国家的复发率、危险因素和临床管理


目的 评估临床不活动后眼结核 （OTB） 葡萄膜炎复发的风险，分析与复发相关的临床因素并描述复发的管理策略。方法 对荷兰鹿特丹伊拉斯谟 MC 诊断的 OTB 患者的 10 年患者登记进行了一项回顾性研究。用 Kaplan-Meier 曲线评估葡萄膜炎复发的时间，并分析复发的危险因素。结果 共确定 93 例 OTB 病例，其中 75 例患者在治疗后出现临床无活动。达到葡萄膜炎不活动的中位时间为 3.97 个月。在临床不活动后 20.7 个月的中位随访 （Q1-Q3： 5.2-81.2） 期间，这 75 例患者中有 25 例 （33.3%） 发生葡萄膜炎复发。被认为对初始葡萄膜炎发作治疗反应不佳的患者在达到临床不活动后复发的风险显著高于反应良好的患者（校正 HR=3.84,95% CI：1.28 至 11.51）。25 例复发患者中有 13 例经历了多次葡萄膜炎复发发作，占整个观察期内 78 例眼复发发作。这些发作中超过一半 （78 例中的 46 例，59.0%） 是前葡萄膜炎。大量葡萄膜炎复发发作 （31 次发作，39.7%） 通过局部皮质类固醇得到有效控制。结论 我们的结果表明，大约 1/3 的 OTB 患者在达到临床不活动后会复发。初始病程和对治疗反应不佳可预测长期随访中复发的可能性。局部皮质类固醇对表现为前葡萄膜炎的复发特别有效。数据可根据合理要求提供。