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Shirley P Ma, Lauren Hodgson, Jessica Brennan, Anthony Hall, Richard Stawell, Lyndell L Lim; Sarcoidosis Related Uveitis: the Interplay Between Ocular and Systemic Disease. Invest. Ophthalmol. Vis. Sci. 2016;57(12):No Pagination Specified.
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Sarcoidosis is a multisystem inflammatory disease characterised by non-caseating granulomata and a variable clinical profile. Uveitis is the most common ophthalmic manifestation, however, there is limited literature regarding the nature and temporal profile of disease progression once ocular or systemic sarcoidosis has been diagnosed.Purpose: To document the clinical presentation and prognostic implications of sarcoid uveitis in relation to systemic sarcoidosis.
Retrospective review of 143 records from The Royal Victorian Eye and Ear Hospital and Eye Surgery Associates between October 1990 and April 2014. Only patients with uveitis and presumed or biopsy-proven sarcoidosis (N=113) were included.
Sarcoid uveitis showed a female gender predilection (76 females vs. 37 males, p<0.01), in whom the disease tended to manifest at a later age (53.6 vs. 43.5 years) and followed a more chronic course (67.1 vs 54.8%, p=0.03). Systemic immunosuppression was required in 45.1% of sarcoid uveitis. A significant number of patients (56.6%) developed complications secondary to uveitis and steroid treatment. Uveitis was the initial presenting complaint of sarcoidosis in 78.8%. Subsequent to the sarcoid uveitis diagnosis, 57% experienced disease progression to symptomatic systemic sarcoidosis with the average time to progression being 16.6 months. Pulmonary (43.2%), multi-organ (29.7%) and cutaneous (16.2%) disease were the most commonly encountered extraocular manifestations. In the subset of patients with a pre-existing diagnosis of systemic sarcoidosis, the average time to ocular involvement was 60.3 months.
Our study confirmed the predilection for sarcoidosis to largely affect females in the 4th to 5th decade of life. Significantly, uveitis was the initial presentation of sarcoidosis in the vast majority of our subjects, with symptomatic systemic disease later developing in 56.6% in an average time of 16.6 months. Sarcoid uveitis was often persistent, with a high rate of ocular complications and requirement for systemic immunosuppression.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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