Our opinions about ocular tuberculosis have evolved over past decade or so and particularly changed during last couple of years, and the Collaborative Ocular Tuberculosis Study (COTS) group and studies conducted by them had major impact on our understanding of ocular tuberculosis. Historically, (still in some text books) uveitis had been separated into infectious and non-infectious uveitis, and additionally in uveitis with or without underlying systemic disorder. Times have changed. We now know that uveitis may be the leading manifestation of a generalized systemic disease, which may start or may show the strongest signs in the eye. Often that originally had been an infectious disorder but we also have learned that most infectious disorders, leading to uveitis, are a combination of an immune response and an infectious agent. It even may be that some uveitis entities may have started by an infection, but the inducing uveitogenic agent is an immune response. Easy to see the problems to detect such an infection.
Tuberculosis is able to fulfill all these points. The COTS project has archived a lot of information using international cooperation, analyzing in different age groups different types of uveitis, reaching from the most infectious forms to immune-mediated forms like serpiginous chorioretinitis. The consensus procedure structures have already been used for other consensus meetings (e.g. the Recommendations for vitreoretinal lymphoma). Now, new steps are necessary, e.g. to cooperate with pulmonologists to clarify that TB is not a privilege of the lung.
These achievements include a standardization (finally!) of the ocular TB nomenclature, the finding that ocular TB mostly is an extrapulmonary TB, comparison between endemic and non-endemic countries.
I am very happy to see this supplement now published in Ocular Immunology and Inflammation: First, as the President of the International Uveitis Study Group, I have to thank the COTS organizers in the name of our members for inviting us from the beginning on to participate in this great project. Second, as the Editor-in-Chief of this journal, I am very happy to see such valuable important studies, now combined in a supplement.
I wish the Organizers that this project will be continued in the new future, and that the results become widely public.
