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- Ocular Tuberculosis (OTB)
Ocular tuberculosis (OTB) is considered an infrequent type of extrapulmonary tuberculosis (TB), which is a widespread concern affecting roughly a third of the world's population. Here at Protheragen, we provide full-scope diagnostics and therapeutics development services for OTB.
Ocular Tuberculosis (OTB) is a form of extrapulmonary tuberculosis that is caused by Mycobacterium tuberculosis (MTB) and has an unusual but significant clinical impact. OTB may cause diseases of the eye and its parts, which include the uvea, retina, choroid, and optic nerve, resulting in a wide range of presentations. OTB has diverse prevalence around the globe, with a particular concentration in regions of widespread tuberculosis. The diagnosis and therapeutic of OTB is difficult due to the lack of a gold standard diagnostic framework, the complex manifestations of the disease, and the lack of microbiological verification from ocular samples.
Fig. 1 The molecular diagnosis of ocular tuberculosis (OTB). (Ludi Z., et al., 2023)
Molecular Diagnostics
The diagnosis of OTB has benefited from newer molecular methods. Nowadays, NAAT methods, like PCR, can isolate and identify MTB DNA from ocular fluids and tissues. Multi-target PCR which amplifies several MTB gene targets simultaneously, has been found to be more sensitive than single-gene target methods. Other methods include detection of drug resistant tuberculosis by GeneXpert MTB/RIF assay and Line Probe Assay (LPA) which are helpful in tailoring the correct therapeutic regimen.
Immunological Diagnostics
Immunological examinations serve the purpose of aiding in the diagnosis of OTB, including PPD and IGRA tests. These tests measure CMI to MTB antigens. The availability of PPD skin tests is widespread, but their lack of specificity poses a challenge in their interpretation, often leading to false-positives in BCG-vaccinated populations. IGRAs, which estimate the release of interferon-γ in response to MTB-derived antigens, are more specific; however, they are still subject to some degree of low-positive results in regions with low incidence.
| Therapeutics | Target | Description | Stage |
| Anti-Tubercular Therapy (ATT) | Mycobacterium tuberculosis | The standard therapeutic regimen for OTB typically includes a combination of drugs such as isoniazid, rifampicin, pyrazinamide, and ethambutol. | Approved |
| Corticosteroids | Inflammatory Pathways | Used to control intraocular inflammation, especially in cases with severe inflammation or paradoxical worsening. Can be administered systemically or locally (e.g., intravitreal injection). | Approved |
| Immunosuppressants | Immune System | Used in conjunction with ATT to manage severe inflammation and prevent recurrence. Examples include azathioprine, mycophenolate mofetil, and methotrexate. | Approved |
| Anti-VEGF Agents | Vascular Endothelial Growth Factor (VEGF) | Used to manage vascular complications such as choroidal neovascularization or retinal vasculitis. Examples include ranibizumab and bevacizumab, administered via intravitreal injection. | Approved |
| Dexamethasone Intravitreal Implant | Inflammatory Pathways | Provides sustained release of corticosteroids directly into the eye, reducing inflammation and managing macular edema. | Approved |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Protheragen, leveraging its extensive expertise in biological research and development, offers comprehensive services to support OTB diagnostics and therapeutics development.
Protheragen's services are designed to assist researchers and pharmaceutical companies in preclinical studies, facilitating the development of innovative solutions for OTB. If you are interested in our services, please feel free to contact us.
References
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