July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Revised International Criteria for the Diagnosis of Ocular Sarcoidosis
Author Affiliations & Notes
  • Manabu Mochizuki
    Ophthalmology, Tokyo Med Dental Univ Grad Sch, Bunkyo-Ku, TOKYO, Japan
    Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan
  • Justine R. Smith
    Department of Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Hiroshi Takase
    Ophthalmology, Tokyo Med Dental Univ Grad Sch, Bunkyo-Ku, TOKYO, Japan
  • Toshikatsu Kaburaki
    Ophthamology, University of Tokyo School of Medicine, Hongo, Tokyo, Japan
  • Narsing A Rao
    Department of Ophthalmology, USC-Roski Eye Institute, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Manabu Mochizuki, None; Justine Smith, None; Hiroshi Takase, None; Toshikatsu Kaburaki, None; Narsing Rao, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4191. doi:
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      Manabu Mochizuki, Justine R. Smith, Hiroshi Takase, Toshikatsu Kaburaki, Narsing A Rao; Revised International Criteria for the Diagnosis of Ocular Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4191.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To revise diagnostic criteria for ocular sarcoidosis (OS) established by the International Workshop on Ocular Sarcoidosis (IWOS) in 2006 (Ocul Immunol Infl, 2009;17:160-9).

Methods : A consensus workshop was held in April 2017, in Bali, Indonesia, to revise the IWOS criteria. Prior to this workshop, a questionnaire proposing revised criteria and consisting of one item for differential diagnosis, 7 items for ocular clinical signs, 10 items for systemic investigations and 3 classes of diagnostic criteria was circulated to 36 uveitis specialists in 15 countries. Questionnaire items with >75% agreement were taken as consensus agreement; items with <50% agreement were taken as consensus disagreement and items with 50-75% agreement were discussion at the workshop. The later items that were supported by two-thirds of 27 IWOS panelists from 14 countries were taken as consensus agreement.

Results : Thirty of 36 uveitis specialists replied to the questionnaire (83% recovery rate). Fifteen questionnaire items with >75% agreements were incorporated into the revised criteria without discussion at the workshop. Items with <50% agreement were excluded from the revised criteria. Items with 50-75% agreement, which were identified for discussion and vote at the workshop were: bilaterality in ocular signs; increased serum soluble IL-2 receptor and serum Ca in systemic investigations; and definition of probable OS in the diagnostic criteria. At the workshop, new systemic investigations were raised for discussion and vote, including: lymphopenia; increased vitreous CD4/CD8 ratio; and parenchymal lung changes consistent with sarcoidosis. After discussion, bilaterality, lymphopenia, lung parenchymal changes and definition of probable ocular sarcoidosis were supported by a two-third majority of the 27 IWOS panelists, and taken as consensus agreement.

Conclusions : Revised IWOS criteria for the diagnosis of OS have been established for validation in future studies (Table 1).

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Table 1. Revised IWOS criteria for the diagnosis of ocular sarcoidosis (2017)

Table 1. Revised IWOS criteria for the diagnosis of ocular sarcoidosis (2017)

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