Treatments and visual outcomes in patients with ocular sarcoidosis

Abstract

Purpose: To investigate the treatments and visual outcomes in the patients with ocular sarcoidosis (diagnosed + suspected).

Methods: The new patients (304 eyes of 55 men and 114 women) who visited the outpatient clinics of Tokyo University Hospital for the first time from January of 2004 to December of 2009, diagnosed as sarcoidosis and followed-up longer than 6 months, were enrolled to this study. We investigated the treatments, changing of best corrected-visual acuity (BCVA), the reasons of poor visual prognoses (0.7 or less), and the history of ocular surgeries. In the patients who received vitrectomy, we investigated the reasons of the surgery, BCVA before and after vitrectomy, and the reasons of poor visual prognoses.

Results: Mean age was 60.1 ± 16.9 years (men 56.2 years, women 62.0 years) and mean followed-up period was 3.4 ± 2.1 years. In 304 eyes, 54% of eyes of BCVA was 0.8 or better at the first visit and 61% at the last visit. The main reasons of poor visual prognoses were cataract (10%) and vitreous opacities (10%) at the first visit, while those were cataract (7%), glaucoma (6%) and macula degeneration (6%) at the last visit. Periocular corticosteroid injection was administered in 30% of eyes, whereas 7% was received systemic corticostreoids. Thirty-seven percent (111/304) of the eyes received ocular surgeries and 33 eyes (11%) received vitrectomy. In the 30 eyes who had received vitrectomy, BVCAs after vitrectomy were improved in 50% of eyes, not changed in 40%, and aggravated in 10%. The reasons of aggravation of BVCA after vitrectomy were macula degeneration (2 eyes) and optic disc atrophy (1 eye). Pre-operative BCVA was less than 0.6 in all 3 eyes that BCVA were aggravated after vitrectomy.

Conclusions: Visual prognoses of ocular sarcoidosis were good in the majority of the patients. Macula degeneration and optic disc atrophy explained poor prognoses.

Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications • 746 uveitis-clinical/animal model • 762 vitreoretinal surgery