Effect of Anti-Tubercular Therapy Duration (6 Months versus ≥9-Months) on Treatment Outcomes in Serpiginous-Like Choroiditis: A Multicenter Retrospective Observational Study.

PURPOSE: Serpiginous-Like Choroiditis (SLC) is considered to be a subtype of tuberculosis associated uveitis and has been treated with either 6 or 9 months of Anti Tuberculosis therapy (ATT). However, ATT is associated with several adverse effects including an increased risk of ethambutol associated optic neuropathy. The aim of this study was to evaluate the effect of anti-tubercular therapy (ATT) duration (6 months vs ≥ 9 months) on treatment outcomes in SLC.

METHODS

A retrospective observational study of patients with SLC was conducted from two campuses of a tertiary care eye institute identified between January 2015 - June 2024. Eligible patients had received at least 6 months of ATT and had a minimum follow-up of 12 months. Patients were grouped based on treatment duration (6 months and ≥9 months). Both groups were compared for the proportion of eyes experiencing recurrence after cessation of ATT, persistent inflammation at the end of therapy, the change in visual acuity from pre- to post-treatment and the effect of ancillary therapy and treatment modification during and after the course of ATT.

RESULTS

209 eyes of 136 patients were included in the study, with Group 1 (6-months ATT) comprising 129 eyes of 84 patients and group 2 (≥9-months ATT) having 80 eyes of 52 patients. No statistically significant difference was noted with respect to overall recurrence rates (p = 0.887), persistence of inflammation at the end of therapy between the groups (p = 0.74), and change in visual acuity (p = 0.34). Ancillary treatment at onset and treatment modification during and after ATT also did not demonstrate a statistically significant impact on these treatment outcomes (p > 0.05). In this study, 8 patients were documented to develop systemic toxicity, and 2 patients developed ethambutol induced optic neuropathy.

CONCLUSION

Based on this study, there was no significant difference between eyes treated with 6 months and those treated with ≥9 months of ATT.