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An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.

We report a case of Alternaria chartarum sclerokeratouveitis with an unfavorable response to treatment. To the best of our knowledge, there are no previous reports of this fungus invading the sclera. A 68-year-old diabetic farmer male patient presented with a 3-week history of pain and redness and a decrease in visual acuity occurring 5 days before admittance in the right eye. Examination revealed severe mixed hyperemia and a scleral calcified plaque with a surrounding area of ischemia and lysis. The cornea showed diffuse infiltrates, stromal edema, and hypopyon. Initial scrapings were negative, and empiric antibiotics were started. After a fungus was reported, topical and systemic antifungals were initiated, but there was no clinical response. The eye was enucleated. A slow-growing fungus A. chartarum , resistant to voriconazole, was isolated. Fungal etiology must be kept in mind when dealing with infectious scleritis. Despite treatment, the outcome of this case was unfavorable due to the slow-growing nature of the fungus and this strain's resistance to voriconazole.

COMUNICACIONES BrEVES resumen Las vasculitis retinianas secundarias son manifestaciones oculares poco frecuentes de diversas enfermedades con compo-nente autoinmune, como granulomatosis con poliangitis, enfermedad de Behcet, sarcoidosis, lupus eritematoso sistémico y esclerosis múltiple, entre otras. Debido a las repercusiones sistémicas el diagnóstico correcto es de mayor importancia. Los síntomas oftalmológicos más frecuentes son visión borrosa y miodesopsias. En algunos casos se observan signos oftalmo-lógicos altamente sugestivos de ciertas enfermedades como la imagen de periflebitis retiniana en «gota de cera» de la sarcoidosis y el hipopion en la enfermedad de Behcet. Las manifestaciones sistémicas son esenciales para el diagnóstico por lo cual se deben reconocer las principales características de las enfermedades frecuentemente involucradas. Palabras clave: Vasculitis retinianas secundarias. Sarcoidosis. Enfermedad de Behcet. Lupus eritematoso sistémico. Esclerosis múltiple. Abstract Secondary retinal vasculitis are unusual ocular manifestations of several autoimmune diseases, such as granulomatosis with polyangiitis, Behcet disease, sarcoidosis, systemic lupus erythematosus and multiple sclerosis, among others. As a consequence of systemic repercussions the correct diagnosis is of greater importance. The most frequent ophthalmological symptoms are blurry vision and floaters. In some cases highly suggestive ophthalmological signs of certain diseases might be presented, such as retinal periphlebitis also known as "candle wax drippings'' image of sarcoidosis and the hypophion in Behcet disease. Systemic manifestations are essential for a correct diagnosis, therefore main features of the frequently involved diseases shall be identified.

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