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F. Di Matteo, E. Miserocchi, G. Modorati, A. Colucci, L. Berchicci, F. Bandello; Role of Systemic Investigations and Characteristic Ocular Signs for the Diagnosis of Ocular Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3772.
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To evaluate the diagnostic values of systemic investigations and ocular signs in patients with biopsy-proven sarcoidosis.
Forty-four patients with biopsy-proven ocular sarcoidosis and sixty-one control patients with other types of uveitis were included in this retrospective study. Frequencies of systemic investigation results (tubercolin skin test, serum angiotensin-converting enzyme, serum lysozime, and chest X-ray) and ocular signs (mutton fat keratic precipitates or iris nodules, trabecular meshwork nodules or peripheral anterior sinechia, snowball opacities or vitreitis, vasculitis, and chorioretinal lesions) were evaluated. We analyzed sensitivity, specificity, positive and negative predictive value for each single factor and for all the possible combinations.
The incidence of abnormal systemic investigation results, anterior segment signs and vitreous opacites were significantly higher in sarcoidosis patients than in patients with other types of uveitis; on the contrary, the frequencies of vasculitis and chorioretinal lesions were similar in the two groups. The presence of two abnormal systemic investigation results, and three anterior segment and vitreous signs, showed a high diagnostic value for ocular sarcoidosis, although sensitivity was below 0.6.
In the study population, combinations of systemic investigations and clinical signs was a useful, although not highly sensitive, diagnostic tool for the identification of patients with ocular sarcoidosis.
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