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Mari Miyauchi, Hiroshi Takase, Miyuki Tanaka, Manabu Mochizuki, Kyoko Ohno-Matsui; A validation study in a single Japanese institute for the revised international criteria for the diagnosis of ocular sarcoidosis proposed by the 6th International Workshops on Ocular Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4194.
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International criteria for the diagnosis of ocular sarcoidosis was proposed in 2006 (Ocul Immunol Inflamm. 2009;17:160-9) by the International Workshop on Ocular Sarcoidosis (IWOS criteria) aiming at diagnosing sarcoidosis in a combination of noninvasive tests, and the recent 6th IWOS (2017, Bali) has proposed revised IWOS criteria. To validate the revised IWOS criteria, we performed a retrospective, case-control clinical study in Japanese patients with uveitis in a single institute.
We examined 211 uveitis patients consisted of 82 men and 129 women with a mean age of 57 years who newly consulted uveitis clinic of TMDU hospital between 2011 to 2016. The study group consisted of 39 patients with biopsy-proven sarcoidosis and 172 control uveitis patients with other clinical entities including Vogt-Koyanagi-Harada disease, herpetic anterior uveitis, acute anterior uveitis, vitreoretinal lymphoma, idiopathic granulomatous uveitis, idiopathic non-granulomatous uveitis, and some others as controls. Predictive values (sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)) were calculated for 7 clinical intraocular clinical signs, 8 results of systemic investigations, and the diagnostic criteria.
Positivity of the intraocular signs and systemic investigations were higher in biopsy-proven sarcoidosis than in control uveitis except for elevated CD4/CD8 ration in bronchoalveolar fluid which was performed in only one control patient. (Table 1) Based on the combined results of the clinical signs and laboratory tests of the revised IWOS criteria, 39 patients with biopsy-proven sarcoidosis were classified as definite ocular sarcoidosis, and 9 patients and 2 patients with idiopathic granulomatous uveitis in the control group were classified as presumed or probable ocular sarcoidosis respectively. (Table 2) The predictive values of the revised IWOS criteria were calculated to be 1.000 for sensitivity, 0.936 for specificity, 0.780 for PPV, and 1.000 for NPV.
The revised IOWS criteria for the diagnosis of ocular sarcoidosis have high predictive values for diagnosis of ocular sarcoidosis in Japanese patients.
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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