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D Khalatbari, GJ Jaffe; Posterior Segment Involvement in Ocular Sarcoidosis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4256.
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Purpose: To determine the incidence of specific posterior segment findings in ocular sarcoidosis by race and gender in the southeastern United States. Method: We reviewed records for specific posterior segment findings and demographic data at initial exam from 66 consecutive patients with either biopsy-proven or presumed ocular sarcoidosis and active disease who visited Duke University Eye Center in the last five years. Results: Of the 66 patients, 80% were African American (34 female, 19 male) and 20% were Caucasian (11 female, 2 male). A total of 57 patients (86%) had posterior segment involvement. African American patients had 83% and Caucasian patients had 100% posterior segment involvement (P=.34). The most common findings among the 57 patients with posterior segment involvement were vitreous cells (82%), "snowball" lesions (47%), choroidal "punched-out" lesions (37%), periphlebitis (32%), cystoid macular edema (CME) (28%), and posterior vitreous detachment (PVD) (21%). The most common findings in the 44 African American patients with posterior segment involvement were vitreous cells (84%), "snowball" lesions (48%), periphlebitis (34%), and "punched-out" lesions (32%). The most common findings in the 13 Caucasian patients with posterior segment involvement were vitreous cells (77%), "punched-out" lesions (54%), CME (54%), and PVD (31%). Of note was the high rate of CME in Caucasian females (34% vs. 22% in all others [P=0.06]). For patients with posterior segment involvement, Caucasian females also had the highest average age at initial exam (57 years vs. 37 years for all others [P<.001]). Conclusion: Posterior segment findings in ocular sarcoidosis are common regardless of patient race or gender. Of significance, African American patients, noted mainly in past studies for anterior segment findings in ocular sarcoidosis, had a high rate of posterior segment involvement that was similar to that in Caucasians. The frequent occurrence of choroidal "punched-out" lesions is also a noteworthy study finding not previously recognized to be as commonplace. The higher rate of CME among Caucasian females compared to all other groups warrants further study.
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