Uveitis, Anterior Clinical Trial
Official title:
Multicenter, Randomized Study Evaluating the Value of Antitubercular Treatment During Recurent Anterior Uveitis (URBA)
Uveitis accounts for 15% of the causes of legal blindness. The etiological diagnosis of
uveitis is difficult because of the poor bacteriological performance of aqueous or vitreous
fluid analysis. At the end of a medical and paramedical check-up, oriented by the typology of
uveitis, a clinical situation is frequently encountered: idiopathic uveitis with a
Quantiferon test (QFN) positive orienting to an old or recent contact with tuberculosis.
Ocular tuberculosis is often characterized by a partial and transient response to
corticosteroid therapy (local or general), due to predominant hypersensitivity phenomena and
low inoculum. Therefore, antitubercular treatment is recommended for idiopathic posterior
uveitis with positive QFN. This treatment of 6-9 months has shown, in combination with
systemic corticosteroids, its effectiveness on ocular inflammation and significant decrease
in recurrence frequency.
For previous uveitis with QFN positive, there is no study or recommendation in the low
endemic countries on the indication of anti-tuberculosis drugs and practices are variable.
Tuberculous anterior uveitis is distinguished by high rate of relapses and chronic uveitis
upon discontinuation of topic corticosteroid therapy that exposes to broad posterior
synechiae leading to an ocular functional impairment. Optimizing the management of recurrent
anterior uveitis is therefore crucial.
The aim of this prospective, randomized, controlled, open, two parallel arm trial is to
compared antitubercular treatment "add-on "of local corticosteroid therapy to Local
Corticosteroid Therapy Only in patients with recurrent or chronic anterior uveitis.
Primary outcome is the treatment succes defined as uveitis recovery at 3 months and the
absence of recurrence at 18 months of follow-up.
n/a
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