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Toshikatsu Kaburaki, Rie Tanaka, Hisae Nakahara, Jummi Tanaka, Mitsuko Takamoto, Hidetomo Izawa, Hisako Ono, Makoto Aihara; Validation of Revised International Criteria for the Diagnosis of Ocular Sarcoidosis Proposed by International Workshop on Ocular Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4192.
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© ARVO (1962-2015); The Authors (2016-present)
To validate revised diagnostic criteria for ocular sarcoidosis (OS) proposed by the International Workshop on Ocular Sarcoidosis (IWOS) in 2017 in Bali.
We performed the retrospective case-control study in uveitis patients at the Uveitis Clinic of the University of Tokyo Hospital tween July 2015 and September 2017. Chart review was performed with patients of biopsy-proved sarcoidosis (n=56) and those of control uveitis group (n=142) consisting of specific clinical entities of uveitis (n=112) and idiopathic granulomatous uveitis (n=30). Positive ratios of 7 items for ocular clinical signs, 8 items for systemic investigations and 3 classes of diagnostic criteria were evaluated. Predictive values [sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)] were also calculated. The research followed the tenets of the Declaration of Helsinki. All participants provided informed consent. This retrospective study was approved by the Institutional Review Board of The University of Tokyo Hospital.
With the exception of the mutton fat KP/iris nodule and optic disc nodule/granuloma/solitary choroidal nodule, there was a significantly higher incidence of positive results for all clinical signs and laboratory tests in the biopsy-proven sarcoidosis patients than in the control uveitis patients. Based on the combined results of 7 clinical signs and 8 laboratory tests in the revised IWOS criteria, all 56 patients with biopsy proven sarcoidosis were classified as definite ocular sarcoidosis. On the contrary, only 4 patients and 4 patients with specific clinical entities of uveitis in control group were classified as presumed or probable ocular sarcoidosis. Moreover, 5 patients and 2 patients with idiopathic granulomatous uveitis in control group were classified as presumed or probable ocular sarcoidosis. The sensitivity, specificity, PPV, and NPV of the revised IWOS criteria were 1.000, 0.894, 0.789, and 1.000, respectively.
The revised IWOS criteria have high predictive values for diagnosing ocular sarcoidosis, but the criteria remained the possibility of further improvement to increase the specificity.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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