Aims: Our purpose was to detect the rate of initial manifestation of sarcoidosis in the eye. Material and Methods: We conducted a retrospective chart review in a sarcoidosis clinic in Germany. Ophthalmological data were obtained by using a standardized protocol, including the medical history, any comorbidity, onset and type of ocular manifestation that was evaluated by slit lamp, tonometry and fundoscopy. Results: In the cohort of 1,800 patients (mean age 38.1 ± 11.8 years), diagnosis of sarcoidosis was established most commonly by bilateral hilar lymphadenopathy (96.2%), histopathology (46.9%) or other organ manifestations. The initial clinical presentation of sarcoidosis (mean age 34.1 ± 10.8 years) had often been eye manifestation (21.2%). Within this group, anterior uveitis was most common (76.4%), followed by intermediate (17.3%) and posterior uveitis (4.7%). Conclusions: The eye is commonly the first site for manifestation of sarcoidosis. Ophthalmologists have a critical role in establishing the diagnosis of sarcoidosis.

The results show that acetazolamide is a basically effective agent against cystoid macular edema and that a therapeutical trial is justified based on the treatment criteria of this study. The factors limiting the therapeutical effect of acetazolamide cannot yet be evaluated on the basis of the small amount of patients in this pilot-study. Considering the patient data a time factor depending on the period between onset of edema-related symptoms and begin of treatment is likely. In the group of unsuccessfully treated cases we had the patients with the longest period of preexisting edema (more than one year) of the study.

Tear-film deficiencies are common in sarcoidosis patients, even when clinical symptoms are absent. Observations herein suggest that patients with sarcoidosis may not only suffer from deficiencies of the aqueous layer, but also of the mucin and lipid layers.

The spectrum of late AMD can be differentiated in several clinical features. In this consecutive series of 2503 symptomatic AMD patients only appr. 6%% of the patients could be treated with laser treatment according to the results of prospective clinical studies. Because in addition the success of this treatment is very limited, the development of new therapeutic options is one of the major tasks in ophthalmology.