Abstract
Purpose: :
to identify the predictors for poor visual outcome in patients with uveitis and biopsy proven sarcoidosis.
Methods: :
charts of 44 patients with uveitis and biopsy proven sarcoidosis seen between 1997 and 2009 were reviewed. Ocular parameters evaluated at presentation were: location and type of uveitis, visual acuity, presence of posterior synechia, iris nodules, vitritis, snowballs, chorio-retinal lesions, retinal vasculitis, papillitis, macular edema , cataract, glaucoma. Laboratory abnormalities and presence of pulmonary involvement of sarcoidosis were recorded.visual acuity at the end of follow-up of the worst-seeing eye was the outcome considered in the univariable and multivariable analyses. Visual acuity of the worst-seeing eye was stratified into two categories according to the threshold 20/50 (≤ 20/50 and > 20/50).
Results: :
44 Caucasian patients with bilateral uveitis, with a median age at diagnosis of 59 years (IQR 45-67) were studied. The majority of patients presented with panuveitis (52%), granulomatous type (61%), posterior synechia (62%). The most frequent vision-threatening complications were cystoid macular edema (56%) and cataract (56%). The median best corrected visual acuity in the worst seeing eye at presentation and at end of follow-up was respectively 0.4 (IQR 0.26-0.80) and 0.63 (IQR 0.36-1.00. At univariable analysis, the presence of iris nodules (p=0.049), cystoid macular edema (p=0.007) and cataract (p=0.007) were clinical significant conditions for a visual outcome of 20/50 or worse in the worst-seeing eye; higher ages at diagnosis of uveitis (p=0.045) and ages at diagnosis of sarcoidosis (p=0.041) were also significantly associated with a poor visual acuity at follow-up. However, at multivariable analysis, the presence of cystoid macular edema (p=0.034) was the only statistically significant predictor associated with an unfavourable visual outcome.
Conclusions: :
in our study we have attempted to find risk factors for poor visual outcome in patients with uveitis associated to sarcoidosis. Our results suggest that only the presence of cystoid macular edema was significantly associated with a worst visual outcome; further investigations are needed to confirm the role of age, cataract and iris nodules.
Keywords: uveitis-clinical/animal model • clinical (human) or epidemiologic studies: risk factor assessment • autoimmune disease