Abstract
Background: Sarcoidosis is one of the leading causes of uveitis. To date, no studies have assessed the factors specifically related with recovery in ocular sarcoidosis. In this study, we aimed to determine factors associated with ocular and extraocular recovery in patients with sarcoid uveitis. Methods: A retrospective study of sarcoid uveitis, with a three-year minimum follow-up in Lyon University Hospital between December 2003 and December 2019. Patients presented biopsy-proven sarcoidosis or presumed sarcoid. Recovery was defined by a disease-free status, spontaneously or despite being off all treatments for three years or more. Results: 143 patients were included: 110 with biopsy-proven and 33 with presumed sarcoid uveitis. Seventy-one percent were women, the median age at presentation was 53 years, and 71% were Caucasian. Chronic uveitis was the main clinical presentation (75%), mostly panuveitis (48%) with bilateral involvement (82%). After a median follow-up of 83.5 months, recovery was reported in 26% of patients. In multivariable analysis, Caucasian ethnicity (p = 0.007) and anterior uveitis (p = 0.008) were significantly associated with recovery, while increased intraocular pressure was negatively associated (p = 0.039). Conclusion: In this large European cohort, one quarter of patients recovered. Caucasian ethnicity and anterior uveitis are associated with ocular and extraocular recovery.
Highlights
Sarcoidosis is a systemic inflammatory disease of unknown etiology, characterized by noncaseating epithelioid cell granuloma infiltrates in miscellaneous organs [1]
The objective of this study was to determine the factors associated with ocular and extraocular recovery in patients presenting with sarcoid uveitis
Variables at diagnosis used for analysis were sex, age >50 years, ethnicity (Caucasian vs. others), gender, chronicity, anatomical localization, granulomatous uveitis, synechia, increased IOP, vasculitis, chronic macular edema, papillary edema, peripherical multifocal choroiditis, extraocular involvement, abnormal chest imaging (X-ray and/or computerized tomography (CT)) and increased serum angiotensin-converting enzyme (ACE)
Summary
Sarcoidosis is a systemic inflammatory disease of unknown etiology, characterized by noncaseating epithelioid cell granuloma infiltrates in miscellaneous organs [1]. All ocular structures can be involved, uveitis is the most common presentation occurring in 25–50% of sarcoidosis patients [2]. Factors associated with poor visual outcome are late-age onset, black phototype, female gender, underlying chronic systemic disease, ocular posterior segment involvement, chronic cystoid macular edema, multifocal choroiditis, persistent ocular inflammation, and glaucoma [2,4,8,9,10,11]. The factors that have been associated with recovery are an age
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