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E. Miserocchi, G. Modorati, A. Colucci, P. Rama; Evaluation of Clinical Characteristics of Ocular Sarcoidosis in Italian Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):796.
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to evaluate the ocular characteristics, visual outcome and ocular complications of Italian patients diagnosed with ocular sarcoidosis
retrospective study. Medical records of patients with biopsy-proven or presumed ocular sarcoidosis seen at the ocular immunology service, San Raffaele Hospital - Milan, between 1998 to 2007, were reviewed. Main outcome measures evaluated were: demographic data, biopsy site, radiologic abnormalities on chest x-ray and chest CT scan, ocular findings at presentation, visual acuity data and ocular complications occurred during follow-up.
forty-five consecutive patients with bilateral ocular involvement (90 eyes) were included in the study. There was a female predilection (30 female; 15 males); 42 patients were Caucasian, 2 African American and 1 Asian. Patients were followed for a mean follow-up time of 42 months (range 4-120). The mean age at onset of uveitis was 53 years (range 10-84 yrs). Thirty two patients (71%) had diagnosis of biopsy proven sarcoidosis. Pulmonary symptoms were only present in 14 patients (31%). Seventeen patients (37.7%) showed abnormal chest X-ray, while abnormal radiologic signs on chest CT scan were present in 88.8% of patients. Panuveitis was the most frequent location of uveitis encountered (54%) followed by posterior (22%), anterior and intermediate (11%). The most common ocular findings were: vitritis (75%), snow balls (66%), granulomatous keratic precipitates and posterior synechia (60%), choroidal "punched out" lesions (58%), retinal periphlebitis (49%), iris nodules (29%). Ocular complications during follow-up were: cystoid macular edema in 43 eyes (48%), cataract in 36 (40%) and glaucoma in 21 (23%). Fourteen patients (31%) showed a stable visual acuity at end of follow-up, 12 patients (26%) had a visual improvement of at least two lines, and 10 patients (22%) showed a visual deterioration of two lines during follow-up. In thirty-five patients (77%) the uveitis was inactive and under medical control at end of follow-up.
clinical characteristics of italian patients with ocular sarcoidosis are similar to those reported from other countries. Since the majority of patients with biopsy-proven sarcoidosis do not have pulmonary symptoms, chest CT scan is an useful diagnostic tool to detect pulmonary lesions in presumed ocular sarcoidosis. Although posterior segment ocular complications are common, the visual prognosis seems to be good and in the majority of patients the uveitis is controlled with medical therapy.
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