Tuberculin Skin Test as a Diagnostic Tool for Sarcoid Uveitis: A Retrospective Analysis at Ramathibodi Hospital, Thailand

Somsiri Sukavatcharin; Salinthip Chimdist

doi:10.33165/rmj.2026.e271693

Authors

Somsiri Sukavatcharin Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Salinthip Chimdist Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0000-0001-5178-6718

DOI:

https://doi.org/10.33165/rmj.2026.e271693

Keywords:

Sarcoid uveitis, Noninvasive tool, Tuberculin skin test, High-resolution computed tomography chest, Tuberculous uveitis

Abstract

Background: Sarcoid uveitis is rarely diagnosed in tuberculosis-endemic countries like Thailand, despite similar clinical presentations to tuberculous uveitis. Differentiating between the 2 conditions is challenging.

Objectives: To identify the diagnostic value of the tuberculin skin test (TST) for diagnosing sarcoid uveitis and use high-resolution computed tomography (HRCT) chest as a gold standard.

Methods: A retrospective review of medical records was conducted for patients who visited the uveitis clinic between January 2006 and December 2021. The inclusion criteria is the patients who underwent both TST and HRCT as part of the diagnostic workup. TST result < 10 mm, which excluded tuberculous uveitis, was strongly considered for diagnosing sarcoid uveitis, with HRCT finding serving as the gold standard due to the limitation of performing tissue biopsy.

Results: The study included 48 uveitis patients, with 19 (39.6%) showing sarcoidosis on HRCT. Among these, 18 (94.7%) had TST < 10 mm, while 1 (5.3%) had TST ≥ 10 mm. In contrast, of those in the non-sarcoidosis group, 13 (44.8%) had TST < 10 mm and 16 (55.2%) had TST ≥ 10 mm. Statistical analysis revealed a significant association between TST and HRCT (P < .001). The TST's sensitivity, specificity, positive predictive value, and negative predictive value for sarcoid uveitis was 94.7%, 55.2%, 58.1%, and 94.1%, respectively.

Conclusions: This study suggested that TST is a potential noninvasive adjunctive diagnostic tool for sarcoid uveitis. Using TST as a screening tool, due to its high sensitivity, could improve early detection and appropriate management of patients, leading to better clinical outcomes.

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