Demographic-related variations in posterior segment ocular sarcoidosis

Abstract

Objective To compare the frequency of posterior segment involvement (PSI), the prevalence of specific posterior segment signs, and visual acuity in ocular sarcoidosis by patient race, sex, and age. Design Retrospective, cross-sectional observational study. Participants Seventy-six consecutive patients with biopsy-proven or presumed ocular sarcoidosis seen at the Duke University Eye Center between 1989 and 2001. Methods Medical record review. Main outcome measures Patient demographics, presence and laterality of specific posterior segment signs, and visual acuity at initial examination. Results Of the 76 patients, 68% were black (34 female and 18 male) and 32% were white (18 female and 6 male). A total of 68 patients (89%) had PSI: black patients had 85% and white patients had 100% ( P = 0.05). For patients with PSI, white females had the highest mean age at initial examination (58 years compared with 37 years for all others; P = 0.005). The most common findings among the 68 patients with posterior segment disease were vitritis (69%); choroidal “punched-out” lesions (56%); “snowball” lesions (46%); cystoid macular edema (CME; 31%); and periphlebitis, vitreous opacity, and posterior vitreous detachment (29% each). There was a significantly higher prevalence of “punched-out” lesions and CME in whites (79% and 54%, respectively) compared with blacks (43% and 18%, respectively; P = 0.005 each). Additionally, the prevalence of CME was highest in white females (61%) compared with all others (20%; P = 0.002). Patients with vitreous hemorrhage were more likely to be in the youngest age group ( P = 0.02). Female patients with posterior segment disease had a significantly lower visual acuity compared with males in both the better ( P<0.001) and worse ( P = 0.002) eye. Conclusions We have identified variations based on patient race, sex, and age in PSI, specific posterior segment signs, and visual acuity in cases of ocular sarcoidosis.