Aims To assess the risk of uveitis relapse in ocular tuberculosis (OTB) following clinical inactivity, to analyse clinical factors associated with relapses and to describe the management strategies for relapses. Methods A retrospective study was conducted on a 10-year patient registry of patients with OTB diagnosed at Erasmus MC in Rotterdam, The Netherlands. Time-to-relapse of uveitis was evaluated with Kaplan-Meier curve and risk factors for relapses were analysed. Results 93 OTB cases were identified, of which 75 patients achieved clinical inactivity following treatment. The median time to achieve uveitis inactivity was 3.97 months. During a median follow-up of 20.7 months (Q1–Q3: 5.2–81.2) after clinical inactivity, uveitis relapse occurred in 25 of these 75 patients (33.3%). Patients who were considered poor treatment responders for their initial uveitis episode had a significantly higher risk of relapse after achieving clinical inactivity than good responders (adjusted HR=3.84, 95% CI: 1.28 to 11.51). 13 of the 25 relapsed patients experienced multiple uveitis relapse episodes, accounting for 78 eye-relapse episodes during the entire observation period. Over half (46 out of 78, 59.0%) of these episodes were anterior uveitis. A significant number of uveitis relapse episodes (31 episodes, 39.7%) were effectively managed with topical corticosteroids. Conclusions Our results suggest that approximately one-third of patients with OTB will experience relapse after achieving clinical inactivity. The initial disease course and poor response to treatment predict the likelihood of relapse in the long-term follow-up. Topical corticosteroids were particularly effective in relapse presenting as anterior uveitis. Data are available upon reasonable request.

中文翻译：

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眼结核复发：非流行国家的复发率、危险因素和临床管理

目的 评估临床不活动后眼结核 (OTB) 葡萄膜炎复发的风险，分析与复发相关的临床因素并描述复发的管理策略。方法 对荷兰鹿特丹 Erasmus MC 诊断的 OTB 患者 10 年患者登记进行回顾性研究。采用Kaplan-Meier曲线评估葡萄膜炎的复发时间，并分析复发的危险因素。结果共发现 93 例 OTB 病例，其中 75 例患者在治疗后达到临床静止状态。达到葡萄膜炎不活动状态的中位时间为 3.97 个月。在临床不活动后的中位随访 20.7 个月（Q1-Q3：5.2-81.2）期间，这 75 名患者中有 25 名（33.3%）出现葡萄膜炎复发。初次葡萄膜炎发作时被认为治疗反应不佳的患者在达到临床不活动后复发的风险显着高于反应良好的患者（调整后 HR=3.84，95% CI：1.28 至 11.51）。 25 名复发患者中有 13 名经历了多次葡萄膜炎复发，占整个观察期间眼部复发的 78 次。其中超过一半（78 例中有 46 例，59.0%）是前葡萄膜炎。大量葡萄膜炎复发发作（31 次，39.7%）通过外用皮质类固醇得到有效控制。结论 我们的结果表明，大约三分之一的 OTB 患者在达到临床不活动状态后会出现复发。最初的病程和对治疗的不良反应预示着长期随访中复发的可能性。外用皮质类固醇对于前葡萄膜炎复发特别有效。数据可根据合理要求提供。