Keywords
complicated forms of uveitis
T-lymphocytes
humoral immunity
ocular complications
How to Cite
Abstract
In press
Background. Tuberculosis is an infectious disease that can severely affect the visual system, presenting with a broad spectrum of clinical manifestations, including various forms of uveitis. The role of the immune response in tuberculous uveitis is currently receiving increased attention regarding its diagnostic, therapeutic implications, and contribution to the development of ocular complications.
Aim. To investigate the peculiarities of immunological disorders and the development of complications in patients with uveitis of tuberculous etiology.
Materials and Methods. We studied clinical features, disease progression, and immunological parameters in 39 patients (60 eyes; aged [28–87] years; 13 men, 26 women) with relapsing tuberculous uveitis and pulmonary tuberculosis (disease duration [3–32] years). Standard ophthalmological and immunological examinations (first- and second-level tests) were performed. The control groups included 61 patients (98 eyes) with non-tuberculous uveitis and 35 healthy individuals.
Research Ethics. The study was conducted in accordance with the principles of the World Medical Association Declaration of Helsinki (1964–2024) and was approved by the Ethics and Bioethics Committee of Kharkiv National Medical University (Protocol No.5 of May 07, 2025). All patients provided written informed consent prior to participation.
Results. Complicated forms of tuberculous uveitis were identified in 49 eyes (81.7%). These were most frequently observed in generalized (100.0%) and anterior (95.2%) uveitis, while posterior uveitis was complicated in 58.3% of cases. The most common complications were uveal cataract (61.7%) and corneal involvement (46.6%). Immunological assessment revealed an immunodeficiency syndrome with a significant decrease in the number of T-lymphocytes, T-helper cells, and the helper/suppressor ratio (p<0.05) compared to the non-tuberculous group. Suppression of humoral immunity was also observed, manifested by a significantly greater decrease in the number of B-lymphocytes and immunoglobulin G concentration (p<0.05).
Conclusions. Tuberculous uveitis, compared to non-tuberculous etiology, is significantly more often complicated by uveal cataract, keratitis, and uveal glaucoma. Patients with tuberculous uveitis exhibit a significantly more pronounced decline in both cellular and humoral immunity parameters, demonstrating that endogenous immunosuppression plays a major role in the progression of complicated forms of uveitis.
Keywords: ophtalmology, complicated forms of uveitis, T-lymphocytes, humoral immunity, ocular complications.
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