September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Sarcoidosis Related Uveitis: the Interplay Between Ocular and Systemic Disease
Author Affiliations & Notes
  • Shirley P Ma
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  • Lauren Hodgson
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  • Jessica Brennan
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  • Anthony Hall
    Eye Surgery Associates, East Melbourne, Victoria, Australia
  • Richard Stawell
    Eye Surgery Associates, East Melbourne, Victoria, Australia
    Ocular Immunology Clinic , Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  • Lyndell L Lim
    Eye Surgery Associates, East Melbourne, Victoria, Australia
    Ocular Immunology Clinic , Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Shirley Ma, None; Lauren Hodgson, None; Jessica Brennan, None; Anthony Hall , None; Richard Stawell , None; Lyndell Lim, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Shirley P Ma, Lauren Hodgson, Jessica Brennan, Anthony Hall, Richard Stawell, Lyndell L Lim; Sarcoidosis Related Uveitis: the Interplay Between Ocular and Systemic Disease. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Sarcoidosis is a multisystem inflammatory disease characterised by non-caseating granulomata and a variable clinical profile. Uveitis is the most common ophthalmic manifestation, however, there is limited literature regarding the nature and temporal profile of disease progression once ocular or systemic sarcoidosis has been diagnosed.

Purpose: To document the clinical presentation and prognostic implications of sarcoid uveitis in relation to systemic sarcoidosis.

Methods : Retrospective review of 143 records from The Royal Victorian Eye and Ear Hospital and Eye Surgery Associates between October 1990 and April 2014. Only patients with uveitis and presumed or biopsy-proven sarcoidosis (N=113) were included.

Results : Sarcoid uveitis showed a female gender predilection (76 females vs. 37 males, p<0.01), in whom the disease tended to manifest at a later age (53.6 vs. 43.5 years) and followed a more chronic course (67.1 vs 54.8%, p=0.03). Systemic immunosuppression was required in 45.1% of sarcoid uveitis. A significant number of patients (56.6%) developed complications secondary to uveitis and steroid treatment. Uveitis was the initial presenting complaint of sarcoidosis in 78.8%. Subsequent to the sarcoid uveitis diagnosis, 57% experienced disease progression to symptomatic systemic sarcoidosis with the average time to progression being 16.6 months. Pulmonary (43.2%), multi-organ (29.7%) and cutaneous (16.2%) disease were the most commonly encountered extraocular manifestations. In the subset of patients with a pre-existing diagnosis of systemic sarcoidosis, the average time to ocular involvement was 60.3 months.

Conclusions : Our study confirmed the predilection for sarcoidosis to largely affect females in the 4th to 5th decade of life. Significantly, uveitis was the initial presentation of sarcoidosis in the vast majority of our subjects, with symptomatic systemic disease later developing in 56.6% in an average time of 16.6 months. Sarcoid uveitis was often persistent, with a high rate of ocular complications and requirement for systemic immunosuppression.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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