Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 2078
  • Home
  • Print this page
  • Email this page

   Table of Contents      
LETTER TO THE EDITOR
Year : 2015  |  Volume : 63  |  Issue : 12  |  Page : 932-933

Comment on: Donate eyes, not patients!


Consultant, Vitreo Retinal Services, Vasan Eye Care Hospital, Hyderabad, Telangana, India

Date of Web Publication10-Feb-2016

Correspondence Address:
Krishnan Panakanti Tandava
Vasan Eye Care Hospital, No. 12, MIG, Dharmareddy Colony, Opposite J.N.T.U. Junction, Kukatpally, Hyderabad - 500 072, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.176037

Rights and Permissions

How to cite this article:
Tandava KP. Comment on: Donate eyes, not patients!. Indian J Ophthalmol 2015;63:932-3

How to cite this URL:
Tandava KP. Comment on: Donate eyes, not patients!. Indian J Ophthalmol [serial online] 2015 [cited 2020 Jul 6];63:932-3. Available from: http://www.ijo.in/text.asp?2015/63/12/932/176037

Dear Sir,

The article "Donate eyes, not patients!" by Naik MN made an interesting read.[1] The author has rightly stated that we ophthalmologists repose more faith in our colleagues of different specialties rather than our own collective wisdom.

Let us take the case of suspected ocular tuberculosis (TB). Physicians are known to take extreme positions in such scenarios. While a few declare a patient free of TB because of healthy respiratory sounds on auscultation in consonance with a normal chest radiograph completely ignoring the possibility of extrapulmonary TB, some others prefer to treat their patients based on a positive interferon-gamma release assay (IGRA) test. As IGRAs do not differentiate between latent and active TB, there is a risk of patients being subjected to unnecessary therapy with its attendant risks if the patients were to be treated solely on the basis of IGRA. A systematic review studying the efficacy of IGRAs to detect active TB in low- to middle-income countries found the sensitivity to be around 69–83% and specificity to be around 52–61%.[2] Moreover, there was no evidence to suggest that IGRAs were more sensitive than Mantoux test for the diagnosis of active TB. It was found that when IGRA was performed in culture-proven active TB cases, one in four (25%) cases showed a negative IGRA test. Babu et al. have found that QuantiFERON ® TB gold test had a sensitivity of 58% and specificity of 77% to detect active systemic TB and a sensitivity of 82% and specificity of 76% in cases of intraocular TB. They thus inferred that QuantiFERON ® TB gold test by itself may not be of much value in cases of presumed ocular TB.[3]

Similarly, a request for physician clearance prior to anti-vascular endothelial growth factor injections is met with opinions which reveal their lack of depth in this particular aspect of clinical medicine. Hence, we ophthalmologists are better of making our judgments based on the available data rather than seek opinion from physicians who find the queries esoteric![4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Naik MN. Donate eyes, not patients! Indian J Ophthalmol 2015;63:564-5.  Back to cited text no. 1
    
2.
Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC, et al. Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: Systematic review and meta-analysis. J Infect Dis 2011;204 Suppl 4:S1120-9.  Back to cited text no. 2
    
3.
Babu K, Satish V, Satish S, Subbakrishna DK, Abraham MP, Murthy KR. Utility of QuantiFERON TB gold test in a South Indian patient population of ocular inflammation. Indian J Ophthalmol 2009;57:427-30.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
Moja L, Lucenteforte E, Kwag KH, Bertele V, Campomori A, Chakravarthy U, et al. Systemic safety of bevacizumab versus ranibizumab for neovascular age-related macular degeneration. Cochrane Database Syst Rev 2014;9:CD011230.  Back to cited text no. 4
    




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed608    
    Printed5    
    Emailed0    
    PDF Downloaded111    
    Comments [Add]    

Recommend this journal