Abstract
Purpose :
Some uveitis specialists eschew further differentiation of non-infectious uveitis, even though specific uveitic syndromes may have consequences for systemic health. Sarcoidosis is a multisystem inflammatory disease that is a regionally common cause of non-infectious ocular inflammation. The objective of this study was to determine the prevalence and manifestations of cardiac sarcoidosis in patients with ocular sarcoidosis.
Methods :
This was a retrospective cohort study of patients diagnosed with ocular sarcoidosis as defined by the International Workshop on Ocular Sarcoidosis (IWOS) at the University of Louisville from 2017-2020 and the Medical University of South Carolina from 2005-2020. Medical records were first searched for at least a suspected diagnosis of sarcoidosis, then for ocular manifestations of sarcoidosis, and finally for an electrocardiogram (EKG). Patients lacking any of these three components were excluded. Cardiac past medical histories and EKG findings consistent with a sarcoidosis diagnosis were also obtained, including ventricular arrythmias, heart blocks, and paroxysmal ventricular contractions.
Results :
Of the 232 patients with sarcoid uveitis, 20 (8.6%) had known cardiac involvement at the time of ocular diagnosis. Sixteen patients (6.9%) had EKG abnormalities consistent with cardiac sarcoidosis. Eight patients had known histories of cardiac sarcoidosis and three had confounding cardiac histories that explained their EKG findings, leaving five patients (2.2%) with ocular sarcoidosis whose cardiac disease was only identified after a diagnosis of possible, probable, presumed, or definite ocular sarcoidosis had been made. Four patients with relevant EKG findings had this study done within 6 months of their diagnosis of sarcoidosis.
Conclusions :
Nearly 10% of patients with ocular sarcoidosis have manifestations of cardiac sarcoidosis, some of whom were diagnosed only after presentation to an ophthalmologist with uveitis. Our results suggest that EKG is a reasonable test to include for patients with signs of ocular sarcoidosis to screen for cardiac issues, which are potentially life-threatening. This work suggests that further differentiation of non-infectious uveitis can have important implications for systemic health. Further research is needed to see if EKG abnormalities can be detected before other cardiac manifestations in this patient population.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.