The role of gamma-interferon tests for suspected tuberculous ocular inflammation

Purpose To evaluate the introduction of new T-cell based blood tests for tuberculosis infection in order to improve the diagnosis of ocular tuberculosis. Methods Patients with presumed ocular tuberculosis from the Ocular Immunology Unit of the hospital of Reggio Emilia underwent both Mantoux skin tests and Gamma Interferon assays to confirm the diagnosis of tuberculosis. Results 8 patients (7/8 male; mean age 58 yrs) were diagnosed with presumed ocular tuberculosis. Three patients presented with serpiginous retinochoroiditis and five with bilateral panuveitis. Four patients had undergone immunosuppressive therapy before the correct diagnosis was made. All the patients were positive both with Mantoux skin test and Gamma Interferon assays (ELISpot and QuantiFERON TB-Gold). They started the specific anti-tuberculous tritherapy, improving significantly in visual acuity and decreasing intraocular inflammation. Conclusion These results confirm the feasibility of these new blood tests in routine clinical work-up. These new methods are important for the ophthalmologist in order to follow and evaluate developments in every method of detection of tuberculosis for the containment of this global public health epidemic.