Hyderabad: A significant number of eye tuberculosis patients may continue to suffer inflammation even after completing full treatment – not due to lingering infection, but because of an overactive immune response, a new study has found.
The findings come from research conducted by teams at LV Prasad Eye Institute (LVPEI), Cole Eye Institute, Cleveland (US); and ABO Eye Institute, Nagpur. The study focused on tubercular serpiginous-like choroiditis (TB-SLC), a form of eye TB that affects the back of the eye and can damage the retina, potentially leading to vision loss.
While TB is commonly associated with the lungs, it can spread through the bloodstream to other organs, including the eyes. Standard treatment involves anti-tubercular therapy-a combination of antibiotics taken over six to nine months-along with steroids to control inflammation.
However, researchers found that inflammation persisted in a notable proportion of patients even after completing therapy. An analysis of 65 patients showed that about 18.5% continued to exhibit signs of inflammation at the end of treatment.
Crucially, the study indicates that this persistent inflammation is driven by the body’s immune system rather than active infection. Patients who received less intensive anti-inflammatory treatment in the early stages were more likely to develop this complication later.
Doctors also observed that early warning signs of persistent inflammation typically emerge within the first three months of treatment.
Vision damage
Most patients with ongoing inflammation responded well to stronger anti-inflammatory medication without any change to their TB treatment regimen. “But when an infectious disease persists after prolonged antimicrobial therapy, it is a challenge for the doctor. Our study demonstrates that factors beyond infection could also be driving late persistence of inflammation in TB-SLC,” said Soumyava Basu, head of uveitis services at LVPEI.
He added that the findings underscore the need to focus not only on eliminating infection but also on aggressively managing inflammation early to prevent long-term vision damage.
