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Eva Jakob, Regina Max, Matthias Becker, Friederike Mackensen; Application of the diagnostic criteria of the International Workshop on Ocular Sarcoidosis in patients with sarcoid uveitis in a tertiary center. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2530.
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Presenting in various forms and leaking of pathognomonic signs, the diagnosis of sarcoid uveitis is challenging. The recently published results of the First International Workshop on Ocular Sarcoidosis (IWOS)* suggest 4 diagnostic categories to standardize the criteria and nomenclature of ocular sarcoidosis. Goal of this study is to assess the clinical application of these criteria in a tertiary center and to analyse the distribution of the different diagnostic subgroups. * International Criteria for the Diagnosis of Ocular Sarcoidosis: Results of the First International Workshop on Ocular Sarcoidosis, C. Herbort et al., Ocul Immunol Inflamm 2009
After identifying all patients in our electronic database who presented 2005 and later to our center with sarcoid uveitis we retrospectively applied IOWS criteria. In our records, we counted bilateral smoldering chronic inflammation, good response to steroids and presence of scd25 also to the diagnostic criteria. So far, we defined patients with biopsy proven or radiologic diagnosis of sarcoidosis as systemic sarcoidosis, patients with a typical uveitis and elevated ACE or scd25 in absence of systemic findings as ocular sarcoidosis. As suggested by IOWS we then classified the detected patients (with and without systemic disease) in the following levels of certainty: Definite, presumed, probable and possible ocular sarcoidosis .
So far, we analyzed the data of 179 patients presenting the first time between 2005 and 2011. They were classified as following: 26% definite, 35% presumed; 8% probable; and 1% possible ocular sarcoidosis. Not fulfilling all criteria for one of the groups 25% of the patients who in our records were clinically diagnosed as sarcoidosis were not suitable for one of the groups. For the conference, we well be able to present the complete data of all patients who presented from 2005 until end of 2012.
Taking into account the difficulties of a retrospective analysis, the criteria of IOWS were applicaple in most of our patients. However, we had several patients diagnosed with sarcoid uveitis by us, who could not be classified in one of the suggested subgroups. Reason for this might be that we take into consideration more symptoms (smoldering chronic inflammation, good response to steroids, sCD25 elevation, skin symptoms) for the diagnosis.
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