ArticleJournal of ophthalmic inflammation and infection2026
Utility of the Collaborative Ocular Tuberculosis Study (COTS) calculator in the management of a case of frosted branch angiitis secondary to presumed intraocular tuberculosis - a case report.
Article in Journal of ophthalmic inflammation and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo illustrate the application of the Collaborative Ocular Tuberculosis Study (COTS) calculator in guiding the management of a case of frosted branch angiitis (FBA) secondary to presumed intraocular tuberculosis (TB).
methodsRetrospective case report.
resultsA 33-year-old Indonesian female, with no significant past medical history except for previous exposure to pulmonary tuberculosis in childhood, presented with acute blurring of vision, redness, and pain in the right eye for one day. On eye examination, her right eye exhibited a visual acuity of counting fingers at 2 m and a normal IOP of 18 mmHg. The anterior chamber of the right eye showed 3 + cells, while the fundus revealed retinal vasculitis in a classic FBA-like pattern and macular edema. The left eye had a visual acuity of 6/9, with normal findings on fundus examination. Fundus fluorescein angiogram showed predominantly venular leakage with optic disc leakage. Systemic evaluation showed a positive QuantiFERON-TB Gold test and a weakly positive Mantoux test (6 mm with 1 TU), with no radiological evidence of active pulmonary TB on chest X-ray. Based on clinical assessment, COTS calculator inputs, and multidisciplinary discussion, anti-tubercular therapy (ATT) was deferred. The patient was treated with systemic corticosteroids, resulting in resolution of macular edema and recovery of visual acuity to 6/6.7 in both eyes at 3 months. Within a span of two months with steroidal treatment alone, she experienced complete resolution of cystic macular edema and achieved a BCVA of 6/6.7 in both eyes.
conclusionThe COTS calculator may support clinical decision-making in selected cases of presumed intraocular TB; however, management should be individualized, supported by multidisciplinary input, and accompanied by close long-term follow-up.
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