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Cohort studyClinical ophthalmology (Auckland, N.Z.) · 2026

Assessing the Combined Diagnostic Value of Serum ACE Levels, Mantoux Test and Lymphopenia in Uveitis Patients from a Tertiary Eye Care Center in Southern India.

Harsha Puthanveettil, Siva Raman Bala Murugan, Bharat Gurnani … Srinivasan Sanjay

OphthalmologyCohort study

Elevated serum angiotensin-converting enzyme distinguishes ocular sarcoidosis from ocular tuberculosis in uveitis

Assessing the Combined Diagnostic Value of Serum ACE Levels, Mantoux Test and Lymphopenia in Uveitis Patients from a Tertiary Eye Care Center in Southern India.

Harsha Puthanveettil … Srinivasan Sanjay

Clinical ophthalmology (Auckland, N.Z.) · 2026

Purpose

To evaluate the diagnostic utility of serum angiotensin-converting enzyme (angiotensin-converting enzyme) levels, along with Mantoux test and lymphocyte count, in patients with uveitis, with particular emphasis on differentiating ocular sarcoidosis and ocular tuberculosis.

Methods

This prospective observational study was conducted at a tertiary eye care center in South India from December 2020 to June 2022.

n = 118 eyes

Results

higher blood angiotensin-converting enzyme test result more strongly points to sarcoidosis over tuberculosis

Sarcoidosis

89.5%

Tuberculosis

33.3%

More results

The cohort had a mean age of 44.52±13.77 years with near-equal gender distribution (50.5% males).

Anterior uveitis was most common (38.1%), followed by intermediate (18.6%) and posterior uveitis (16.9%).

More results

Posterior uveitis was significantly higher in tuberculosis (53.3% vs 10.7%, p=0.002), while intermediate uveitis was more common in sarcoidosis (46.4% vs 6.7%, p=0.008).

Mantoux positivity was higher in tuberculosis (58.3%; AUROC 0.835).

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Conclusion · 1 of 2

Serum angiotensin-converting enzyme is a useful adjunctive biomarker in the diagnosis of ocular sarcoidosis but lacks specificity when used in isolation.

Conclusion · 2 of 2

A combined approach incorporating serum angiotensin-converting enzyme, Mantoux test, and lymphocyte count enhances diagnostic precision in uveitis, particularly in distinguishing sarcoidosis from tuberculosis in endemic regions.

Assessing the Combined Diagnostic Value of Serum ACE Levels, Mantoux Test and Lymphopenia in Uveitis Patients from a Tertiary Eye Care Center in Southern India.

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