Abstract
Purpose :
Sarcoidosis is a granulomatous inflammatory disease that can affect any organ including the central nervous system (CNS) and the eyes. This cross-sectional study aimed to investigate retinal neural structure in patients with different clinical manifestations of sarcoidosis.
Methods :
A total of 200 eyes of 103 biopsy-verified sarcoidosis patients without diabetes mellitus were included and categorized into four groups according to their phenotype: 1) sarcoidosis without ocular or CNS affection (non-ocular/no-CNS), 2) ocular sarcoidosis, 3) CNS sarcoidosis, and 4) combined ocular and CNS sarcoidosis (ocular/CNS).
Best corrected visual acuity (BCVA) was assessed. Swept source optical coherence tomography (SS-OCT) was obtained (Topcon Swept Source DRI OCT Triton), with measurements of central macular thickness (CMT), retinal thickness (RT), retinal nerve fiber layer (RNFL), and ganglion cell layer (GCL) thickness. Differences in retinal neural structures between groups were evaluated by Kruskal-Wallis Test and pairwise by Wilcoxon Rank Sum Test.
Results :
The mean age of participants was 50.4 years (SD13.4 years), 52% were males, and 54.5% of patients had a duration of sarcoidosis above five years. Median BCVA was above 80 Early Treatment Diabetic Retinopathy Study letters in all groups.
Eyes of the non-ocular/no-CNS group had a lower CMT and RNFL than the ocular sarcoidosis group (p=0.003 and p=0.011). Likewise, the RNFL was thinner in non-ocular/no-CNS eyes compared to ocular/CNS (p=0.002) and in those with ocular sarcoidosis compared to the CNS group (p=0.029).
In subgroup analyses of patients with a duration of sarcoidosis above five years, the CMT in eyes of the non-ocular/no-CNS group was thinner than all other groups: ocular (p=0.0001), CNS (p=0.0002) and ocular/CNS (p=0.029). Moreover, there was a thickening of CMT in the ocular group compared to the CNS group (p=0.002). Similarly, RT and RNFL were thinner in the non-ocular/no-CNS group compared to both the ocular (p<0.0001 and p=0.13) and the ocular/CNS group (p<0.0001 and p=0.03). Finally, a thickening in those variables was also observed in the ocular compared to CNS group (p=0.01 and p=0.0004)
Conclusions :
In particular for patients with a long duration of sarcoidosis, these results indicate increasing retinal thickening in patients with ocular involvement of sarcoidosis.
This is a 2021 ARVO Annual Meeting abstract.