Conjunctival Biopsy in Sarcoidosis

Chung, Yu-Mei; Lin, Yingcheng; Huang, Der-Chen; Hwang, De‐Kuang; Ho, Donald Ming Tak

doi:10.1016/s1726-4901(09)70311-9

Cited by 41 publications

(16 citation statements)

References 14 publications

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“…Conjunctival tissue biopsy is less invasive than lung biopsy, but controversial results were reported on its diagnostic value. In the last few years, one study has reported on high efficacy of undirected conjunctival biopsy and recommended this procedure as a first biopsy attempt in patient suspected with sarcoidosis (Chung et al. 2006).…”

Section: Discussionmentioning

confidence: 99%

Peripheral multifocal chorioretinitis

Koop

Ossewaarde

Rothová

2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To investigate the prognosis and complications in patients with peripheral multifocal chorioretinitis (PMC). PMC is a posterior or panuveitis characterized by chronic bilateral vitritis and punched-out lesions in the peripheral retina which occurs commonly in elderly white women and is associated with sarcoidosis. Prognosis and complications are largely unknown. Methods: A structured literature search in PubMed, Embase and Cochrane was performed to identify relevant articles. Articles were screened, and the remaining articles were critically appraised based on relevance and validity. Results: The search yielded 267 articles. Eight relevant articles were retrieved. All studies reported on moderate visual impairment. Macular oedema occurred in 60% of the patients with PMC (range, 0-71%), glaucoma in 27% (range, 25-43%) and an epiretinal membrane in 21% (range, 0-28%). In total, 47% had proven or presumed sarcoidosis. Treatment usually comprised topical corticosteroids, periocular steroid injections and systemic corticosteroids regularly in combination with methotrexate. Conclusion: The prognosis of patients with PMC is characterized by a rather poor visual outcome and the relatively high prevalence of complications. PMC is strongly associated with sarcoidosis. Solid proof for the treatment efficacy of PMC is lacking.

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Section: Discussionmentioning

confidence: 99%

Peripheral multifocal chorioretinitis

Koop

Ossewaarde

Rothová

2012

Acta Ophthalmologica

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“…There is a significant variability in the literature, however, the reported age at initial diagnosis varies from ,40 yrs [27,28], to ,40 yrs [29,30] to 48 yrs [31]. Approximately one-third of the patients in the ACCESS study were o50 yrs of age at the time of diagnosis [32].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sarcoidosis in Switzerland is associated with environmental factors

Deubelbeiss¹,

Gemperli²,

Schindler³

et al. 2009

European Respiratory Journal

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The current study aimed to investigate incidence, prevalence and regional distribution of sarcoidosis in Switzerland with respect to environmental exposures.All sarcoidosis patients hospitalised between 2002 and 2005 were identified from the Swiss hospital statistics from the Swiss Federal Office for Statistics (Neuchâtel, Switzerland). Regional exposure characteristics included the regional distribution of different industrial sectors, agriculture and air quality. Co-inertia analysis, as well as a generalised linear model, was applied.The prevalence of ''ever-in-life'' diagnosed sarcoidosis, currently active sarcoidosis and sarcoidosis requiring hospitalisation was 121 (95% CI 93-149), 44 (95% CI 34-54) and 16 (95% CI 10-22) per 100,000 inhabitants, respectively. The mean annual incidence of sarcoidosis was 7 (95% CI 5-11) per 100,000 inhabitants. The regional workforce in the metal industry, water supply, air transport factories and the area of potato production, artificial meadows (grassland) and bread grains were positively associated with the frequency of sarcoidosis.The prevalence of sarcoidosis was higher than assumed based on former international estimates. Higher frequency was found in regions with metal industry and intense agriculture, especially production of potatoes, bread grains and artificial meadows.

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“…The recovery of granulomas with conjunctival biopsy using careful sectioning technique approaches the yield obtained from other tissue sites [16,17], especially when conjunctival pathology such as nodules, follicles, or fibrous scarring is present [4,12,18]. No false positives have been reported in previous studies [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Definitive diagnosis requires histologic evidence of non-caseating, granulomatous inflammation, commonly from biopsy of mediastinal lymph nodes. Another potential biopsy site is the conjunctiva, with a reported diagnostic yield ranging from 20% to 70% with blind biopsies [1-4] and 36% to 75% with directed biopsies [5-8]. This wide range may be explained by different tissue sectioning and analysis techniques; however, few studies describe their histologic methodology.…”

Section: Introductionmentioning

confidence: 99%

Directed conjunctival biopsy and impact of histologic sectioning methodology on the diagnosis of ocular sarcoidosis

Bui

García-González

Patel

et al. 2014

J Ophthal Inflamm Infect

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Background: Sarcoidosis is an idiopathic, multi-system, granulomatous disease with well-described ocular manifestations. However, other uveitic etiologies can manifest in a similar fashion, and ocular disease may precede systemic manifestations. Definitive diagnosis requires histologic confirmation of non-caseating granulomatous inflammation. This study reports the diagnostic yield of directed biopsy of conjunctival follicles in patients with uveitis suspected to be secondary to sarcoidosis, and compares an institutional standard tissue sectioning method to a multi-plane technique. Results: A retrospective analysis was performed of all patients who underwent directed conjunctival biopsy for suspected ocular sarcoidosis. A total of eight patients were identified; all were females. Directed conjunctival biopsy was positive in three of seven patients using standard histologic processing method, a yield of 43%. Using the multi-plane technique increased the cumulative yield to 63%.

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Conjunctival Biopsy in Sarcoidosis

Abstract: Blind and bilateral conjunctival biopsy, due to its ease, safety and specificity, could be the first biopsy inpatients with clinical or chest X-ray abnormalities suggesting sarcoidosis. None of our patients with positive biopsy had nodular lesions.

Cited by 41 publications

References 14 publications

Peripheral multifocal chorioretinitis

Peripheral multifocal chorioretinitis

Prevalence of sarcoidosis in Switzerland is associated with environmental factors

Directed conjunctival biopsy and impact of histologic sectioning methodology on the diagnosis of ocular sarcoidosis

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