# Tuberculosis as a significant cause of uveitis-related blindness: current referral trends at a tertiary uveitis center in Indonesia

## TL;DR

In Indonesia, nearly 10% of uveitis patients have active tuberculosis, and over half experience blindness in their worse-seeing eye.

## Contribution

This study highlights the high prevalence of active TB among uveitis patients in Indonesia and the significant risk of blindness.

## Key findings

- Active systemic TB was diagnosed in 9.8% of uveitis patients.
- Blindness in the worse-seeing eye was observed in 56.1% of uveitis patients.
- Most TB-related uveitis patients sought care due to eye problems.

## Abstract

•Active systemic tuberculosis was diagnosed in approximately one in 10 patients with uveitis.•More than half of referred patients with uveitis had blindness in worse-seeing eye.•Eye problems were the main reason patients with uveitis with active tuberculosis sought medical care.

Active systemic tuberculosis was diagnosed in approximately one in 10 patients with uveitis.

More than half of referred patients with uveitis had blindness in worse-seeing eye.

Eye problems were the main reason patients with uveitis with active tuberculosis sought medical care.

Uveitis may lead to blindness if improperly treated, yet the data on blindness due to uveitis, particularly, in low-resource countries, remain limited. In high–tuberculosis (TB) burden countries such as Indonesia, active systemic TB is among the leading causes of infectious uveitis. The combined impact of blindness, uveitis, and TB presents a substantial health and socioeconomic burden. This study aimed to assess the current situation of uveitis referrals, particularly, on the proportion of uveitis with active systemic TB and the proportion of blindness in TB-related uveitis.

We retrospectively analyzed 1-year data from 164 newly referred patients with uveitis at a single tertiary eye Hospital in Indonesia.

Active systemic TB was diagnosed in approximately one in 10 patients with uveitis (16 of 164, 9.8%). At initial presentation, blindness in the worse-seeing eye was noted in 56.1% (92 of 164) of patients. The proportion of blindness was slightly higher in patients with uveitis with active systemic TB and those with no identifiable cause but positive Quantiferon-TB Gold Plus, compared with other uveitis cases, although not statistically significant (56.3%, 61.1%, and 51.3%, respectively; P = 0.489). Most patients with uveitis with active systemic TB (14 of 16, 87.5%) sought medical attention due to ophthalmological symptoms.

Active TB case finding in patients with uveitis, especially in high–TB burden settings, is obligatory to prevent severe morbidity.