International Criteria for the Diagnosis of Ocular Sarcoidosis: Results of the First International Workshop on Ocular Sarcoidosis (IWOS)

Herbort, Carl P.; Rao, Narsing A.; Mochizuki, Manabu; Commi, the members of the Scientific

doi:10.1080/09273940902818861

Cited by 470 publications

(316 citation statements)

References 27 publications

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“…17 The diagnosis of specific manifestations and etiologies of uveitis was based on the clinical picture and on classification according to international criteria. [18][19][20][21][22][23][24] Therefore, patients were grouped into (1) infectious uveitis, (2) specific clinical entity (HLA-B27-positive anterior uveitis, Fuchs heterochromic uveitis, PosnerSchlossman syndrome, multifocal choroiditis, punctate inner choroidopathy, serpinginous choroidopathy, multiple evanescent white dot syndrome, birdshot choroidopathy, presumed ocular histoplasmosis syndrome, and acute posterior multifocal placoid pigment epitheliopathy), (3) uveitis associated with systemic disease, and (4) idiopathic uveitis in cases in which a specific diagnosis, either ocular or systemic, could not be made.…”

Section: Clinical Examinationmentioning

confidence: 99%

Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis

Grajewski

Boelke

Adler

et al. 2016

Eye

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Purpose To analyze the macular structure in a large series of consecutive patients with different types of uveitis using spectraldomain optical coherence tomography (SD-OCT). Patients and methods Five hundred eyes of 500 consecutive patients with anterior, intermediate, posterior, and panuveitis underwent standardized macular examination using SD-OCT. Central retinal thickness (CRT), macular volume (MV), and presence of cystoid macular edema (CME), diffuse macular edema (DME), serous retinal detachment (SRD), epiretinal membrane with (ERM+) and without (ERM − ) retinal surface wrinkling were determined. Results The anatomic location of inflammation affected significantly CRT and MV (Po0.001, respectively), with the highest values in intermediate and panuveitis. CME was seen in 25% of all uveitic eyes, DME in 11%, SRD in 8%, ERM+ in 18%, and ERM − in 13%. CME was most frequent in intermediate (40%) and panuveitis (36%); DME was most frequent in panuveitis (18%) and posterior uveitis (17%); SRD was most frequent in panuveitis (15%) and posterior uveitis (10%); ERM+ was most frequent in panuveitis (45%) and intermediate uveitis (30%); and ERM − was most frequent in intermediate (14%) and posterior uveitis (15%). Conclusion SD-OCT of the macula is recommended for all uveitis patients. CRT, MV, and the incidence of CME were highest in intermediate and panuveitis.

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Section: Clinical Examinationmentioning

confidence: 99%

Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis

Grajewski

Boelke

Adler

et al. 2016

Eye

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“…12 All three patients with positive chest CT findings were females aged older than 50 years who suffered from chronic PMC characterised by bilateral vitritis associated with peripheral retinal punched-out lesions (Table 1 and Figure 2). All developed cystoid macular oedema (CME) and epiretinal membranes (Table 1).…”

Section: Resultsmentioning

confidence: 94%

“…Unfortunately, because of nonmedical reasons, tissue diagnosis could not be obtained in the remaining two patients with pulmonary abnormalities and their diagnoses remained presumed. 12 The value of CXR for diagnosis of sarcoidosis in patients with uveitis was repeatedly debated, and it is currently agreed that the chest CT is more sensitive than the CXR. 2,14,15 In addition, serum ACE and lysozyme levels are useful for the screening of uveitis patients, 1,16 however, these serological tests were not available in our institute.…”

Section: Discussionmentioning

confidence: 99%

Ocular sarcoidosis in Thailand

Pathanapitoon

Goossens

Tilborg

et al. 2010

Eye

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Purpose To determine the prevalence of pulmonary sarcoidosis in patients with uveitis from the University Referral Centre in Thailand and to report on their clinical characteristics. Methods We performed a retrospective review of results of radiological examinations of 209 consecutive new patients, diagnosed with uveitis. In patients with signs of pulmonary sarcoidosis, we reviewed clinical characteristics including age, gender, laterality and anatomical location of uveitis, and complications.Results From 209 chest X-ray (CXR) examinations, one patient exhibited radiological signs typical of stage 1 sarcoidosis. Chest CT of three patients with posterior multifocal chorioretinitis (PMC) revealed abnormalities suggesting the diagnosis of pulmonary sarcoidosis. All PMC patients were females older than 50 years; they had no pulmonary complaints and their CXRs were without abnormalities. Conclusion Ocular sarcoidosis is prevalent in Thailand and our findings suggest that possibly more patients with sarcoidosis would be identified if diagnosis was thought of and ancillary tests were performed.

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“…The First International Workshop on Ocular Sarcoidosis (FIWOS) recommended four levels of certainty for diagnosis in patients in whom other possible causes of uveitis had been excluded: 24 (1) biopsy-supported diagnosis with a compatible uveitis was labelled as definite ocular sarcoidosis; (2) if biopsy was not done but the chest X-ray was positive showing bihilar lymphadenopathy associated with a compatible uveitis, the condition was labelled as presumed ocular sarcoidosis; (3) if biopsy was not done and the chest X-ray did not show bihilar lymphadenopathy but there were three of the classic intraocular signs and two positive laboratory tests, the condition was labelled as probable ocular sarcoidosis; and (4) if lung biopsy was done and the result was negative but at least four classic intraocular signs and two positive laboratory investigations were present, the condition was labelled as possible ocular sarcoidosis. Only patients with definite, presumed or probable sarcoidosis were included in this study.…”

Section: Diagnostic and Inclusion Criteriamentioning

confidence: 99%

Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis

Mehta

Sim

Keane

et al. 2015

Eye

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Aim The aim of this study is to characterise the choroidal features of patients diagnosed with sarcoid-and tuberculosis (TB)-associated granulomatous uveitis using spectral domain optical coherence tomography (OCT). Methods Twenty-seven patients (27 eyes) diagnosed with sarcoid-(13 eyes) and TB (14 eyes)-related uveitis were included in this retrospective, cross-sectional study. Over a sixmonth period, patients diagnosed with sarcoid and TB granulomatous uveitis were scanned using enhanced depth imaging OCT. Clinical and demographical characteristics were recorded, including the method of diagnosis, disease activity, site of inflammation (anterior or posterior), treatments, and visual acuity (VA). Manual segmentation of the choroidal layers was performed using custom image analysis software. Results The main outcome measure was OCT-derived thickness measurements of the choroid and choroidal sublayers (Haller's large vessel and Sattler's medium vessel layers) at the macula region. The ratio of Haller's large vessel to Sattler's medium vessel layer was significantly different at the total macula circle in eyes diagnosed with TB uveitis (1.47 ( = 140.71/95.72 μm)) compared with sarcoid uveitis (1.07 ( = 137.70/128.69 μm)) (P = 0.001). A thinner choroid was observed in eyes with a VA ≥ 0.3 LogMAR (Snellen 6/12; 198.1 μm (interquartile range (IQR) = 147.0-253.4 μm) compared with those with VA o0.3 LogMAR (292.4 μm (IQR = 240.1-347.6 μm)) at the total macula circle (P = 0.004). At the foveal central subfield, the median choroidal thickness was 336.8 μm (IQR = 272.3-375.4 μm) in active compared with 239.3 μm (IQR = 195.3-330.9 μm) in quiescent disease (P = 0.04). Conclusion A disproportionately enlarged Sattler's layer may indicate a diagnosis of sarcoid-related uveitis, and choroidal thickening may be a feature of active granulomatous uveitis.

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International Criteria for the Diagnosis of Ocular Sarcoidosis: Results of the First International Workshop on Ocular Sarcoidosis (IWOS)

Cited by 470 publications

References 27 publications

Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis

Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis

Ocular sarcoidosis in Thailand

Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis

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