Uveitis and Interferon-Gamma Release Assay (IGRA) status: diagnostic implications of a positive IGRA test

Abstract Purpose To evaluate and compare six-month clinical outcomes between uveitis patients with positive versus negative Interferon-Gamma Release Assay (IGRA) results, focusing on treatment success and complication rates. Methods This prospective exploratory cohort study enrolled 54 adult patients with active uveitis at a tertiary eye care center. Participants were stratified into IGRA-positive and IGRA-negative groups based on baseline QuantiFERON test results. Patients received tailored treatment, including corticosteroids and anti-tubercular therapy (ATT) when indicated. Clinical follow-up occurred over a six-month period, and data were collected on visual acuity, ocular complications (e.g., glaucoma, cystoid macular edema), and overall treatment outcomes. Results At baseline, IGRA-positive patients presented with more severe disease, including higher rates of visual impairment (43% vs. 27%) and blindness (9.5% vs. 3.0%). By six months, both groups had comparable treatment success rates. IGRA-positive patients experienced a lower rate of visual deterioration and showed clinical improvement despite their more severe baseline status. Although not statistically significant, IGRA-positive patients had higher incidences of glaucoma (9.5% vs. 3.0%) and cystoid macular edema (24% vs. 9.1%). Treatment failure was more frequent among patients with bilateral or intermediate uveitis, irrespective of IGRA status. Conclusion No statistically significant difference in six-month outcomes was observed between the groups. Treatment success rate was noted to be lower in IGRA-positive patients although not statistically significant. Understanding the nuances of treatment success rate in uveitis patients, alongside stricter adherence monitoring and clear relapse management plans, could improve outcomes and provide a foundation for developing standardized treatment protocols in the future.