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G. Davuluri, G.F. Reed, J.A. Smith, B. Rubin, R.B. Nussenblatt, G.A. Levy–Clarke; Ocular Complications of Sarcoidosis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):585.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the proportion and types of ocular complications in ocular sarcoidosis patients.
Retrospective review of existing records of patients presenting at the National Eye Institute Uveitis clinic for follow–up between July 2004 and June 2005. Main outcome measures: Type of complications related to sarcoidosis associated uveitis.
There were 20 patients, 5 males and 15 females, ranging in age from 9 to 73 years (median age 35.6). Fifteen of the patients (75%) were African–American, four (20%) were white, and one (5%) was Asian. All patients had biopsy–proven ocular sarcoidosis. The onset of ocular symptoms ranged from nine years before the diagnosis of sarcoidosis (biopsy proven) to eleven years after the diagnosis had been made. All except one patient had bilateral disease. Anterior uveitis accounted for 5%, anterior/intermediate uveitis for 5%, intermediate uveitis for 25%, and panuveitis for 65% of patients. Of the patients that had follow–up at the NEI, the mean follow–up period was 8.5 years (range, 2 to 22 years). Approximately 89% of all patients had 1 or more complications at the time of initial consultation. At the last follow–up visit, 100% of the patients had at least 1 complication and 62.5% had three or more complications. There were a total of 40 complications of all types. Of the anterior segment complications, cataract (50%), glaucoma (50%), and posterior synechiae (37.5%) were the most common. Posterior pole complications included cystoid macular edema (25%); vitreous opacification (18.8%); optic nerve edema (6.7%); and epiretinal membrane (6.3%). At initial presentation, thirteen patients (75.5%) had at least one eye with vision less than 20/40 and six (35.3%) had vision less than 20/200. At the last follow–up visit, eleven patients (68.8%) had less than 20/40 vision and six (37.5%) had less than 20/200 vision. Fourteen patients (70%) had ocular surgery, and 12 of these were bilateral. The majority of these patients (85.7%) had cataract surgery, of which 83% had bilateral cataract removal. Four patients (28.6%) underwent glaucoma surgery (3 valves, 1 filtering procedure). Twelve patients (66.7%) were on systemic immunosuppressive therapy at initial presentation.
Biopsy–proven ocular sarcoidosis patients have a significant number of complications, many of which require surgical intervention; cataract and glaucoma were the leading causes.
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