Session Title: Free Paper Session 10: Uveitis
Session Date/Time: Friday 08/09/2017 | 11:00-12:30
Paper Time: 11:48
Venue: Room 111
First Author: : M.Sharma INDIA
Co Author(s): : A. Deokar A. Agarwal N. Singh R. Singh R. Bansal V. Gupta
To measure and analyze the serum cytokines profile in patients of tubercular multifocal serpiginoid choroiditis (TB-MSC) receiving anti-tubercular (ATT) with corticosteroids.
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh
Methods: In this prospective study, patients with active TB MSC were included. Serum levels of interferon (IFN)-γ, interleukin (IL)-10, and tumour necrosis factor (TNF)-α were analyzed using bead-based immunoassay. The levels of transforming growth factor (TGF)-β were measured using cytokine bead array. Serial measurement was performed at baseline, 1, 3, and 6 weeks after initiation of therapy. Patients developing paradoxical worsening (PW) of TB MSC were identified and their serum levels of cytokines were compared to those patients who showed healing of lesions. Comparison of cytokine levels with baseline values was also performed.
Twelve patients (16 eyes; 4 females) were included in the study. 4 patients showed paradoxical worsening of TB MSC at 3.2 ± 1 weeks after initiation of therapy. Compared to patients who showed healing of lesions, patients with PW showed higher baseline IL-10 (not significant; p=0.28). Among patients developing PW, levels of IFN-γ peaked at 1 week ((p=0.01) and levels of TNF-α peaked at 3 weeks (p=0.02) (coinciding with PW) compared to patients who showed healing. There was no significant difference in TGF-β levels at any time point in either group (p>0.47).
Baseline and serial levels of inflammatory serum cytokines may help in predicting the response to ATT and corticosteroids in TB MSC. Patients with paradoxical worsening may show rise in pro-inflammatory cytokines after initiation of ATT indicating higher bacillary load.