OP0091 TREATMENT OF OCULAR SARCOIDOSIS. STUDY OF 65 PATIENTS OF A SERIES OF 384 PATIENTS FROM A SINGLE UNIVERSITY HOSPITAL

Abstract

Background:Ocular involvement is a relatively frequent and potentially severe complication of sarcoidosis. Oral corticosteroids (OCS) are the first-line treatment. Conventional immunosuppressive agents (cIS) and biological therapy (BT) can be used in refractory cases (1-5).Objectives:To evaluate the treatment and visual outcomes of a cohort of patients diagnosed with ocular sarcoidosis.Methods:Study of a large cohort (n=384) of all consecutive patients diagnosed with sarcoidosis from January 1, 1999 to December 31, 2019 at a single University Hospital. Finally, 344 patients were included according the ATS/ERS/WASOG criteria (Eur Respir J. 1999; 14:735-7). Different ocular manifestations and the following systemic treatments were assessed: a) OCS, b) cIS), c) monoclonal TNF inhibitors, d) Etanercept (ETN), e) Tocilizumab (TCZ). Best Corrected Visual Acuity (BCVA) according to different systemic treatments was compared at diagnosis and after one year of follow-up (Kruskall Wallis test).Results:344 patients were reviewed. From these, 65 (18.9%) presented ocular manifestations as uveitis (83.1%), orbital lesions (7.7%), retinal vasculitis (6.2%), dry eye (6.2%) and scleritis (1.5%). All of them received systemic treatment. BT was particularly used in patients with retinal vasculitis (100%), panuveitis (75%) and orbital lesions (40%). Systemic treatment and BCVA outcome according to ocular manifestations are shown in table. Median BCVA at onset and after one year was 0.6 [interquartile range (IQR) 0.3-0.8] and 0.9 [0.6-1], respectively. No statistically significant differences were observed between systemic treatments in BCVA of patients with uveitis after 1 year of follow-up (Figure).Figure 1.Median [25,75 IQR] BVCA after one year follow up according to type of systemic treatment in sarcoid uveitis.Median BCVA after one year Systemic treatmentAbbreviations: BCVA: Best Corrected Visual Acuity; OCS: Oral Corticosteroids; Conventional IS: Conventional immunosupressants; Monoclonal TNFi: monoclonal tumour necrosis factor inhibitors; ETN: Etanercept; TCZ: Tocilizumab.Conclusion:Panuveitis, intermediate uveitis and orbital lesions, require a more aggressive treatment than other manifestations of ocular sarcoidosis. In uveitis, an important improvement in BCVA after 1 year of follow-up was observed regardless of the type of treatment used.