Non-Invasive Detection of Multinucleated Giant Cells in the Conjunctiva of Patients with Sarcoidosis by In-Vivo Confocal Microscopy

Wertheim, M. S.; Mathers, William D.; Watkins, Angela S.; Mackensen, Friederike; O’Malley, Jean P.; Rosenbaum, James T.

doi:10.1080/09273940600826471

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…In-vivo confocal microscopy of the conjunctiva was successfully used to identify the presence of multinucleated giant cells in patients with sarcoid conjunctival nodules with 100% specificity and 50% sensitivity. 67 The procedure required technical skills and may need an instrument with high resolution and deep penetration ability to improve a sensitivity of the test. Rose-Nussbaumer et al recently reported that anterior segment spectral-domain optical coherence tomography (OCT) could differentiate a predominantly mononuclear pattern of anterior chamber cells in active anterior uveitis associated with sarcoidosis or inflammatory bowel disease from a predominantly polymorphonuclear pattern in HLA-B27-related uveitis.…”

Section: Diagnosis Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

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215

185

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Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations.

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Section: Diagnosis Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

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215

185

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“…For the first time, nCLE granuloma criteria were proposed and validated in a structured approach. Although previously several attempts were made, the proposed CLE granuloma descriptions varied widely and lacked consensus 15–19 . Initial experience with CLE‐imaging in the thorax was gained by inserting the CLE miniprobe through the bronchoscope's working channel and scanning the surface of the airway wall and lung nodules (probe‐based CLE [pCLE]).…”

Section: Discussionmentioning

confidence: 99%

“…With the upcoming of nCLE in interventional pulmonology, distinction on nCLE‐imaging between malignant and granulomatous criteria could be useful. Although some reports described cases of granulomatous CLE‐imaging, the granuloma descriptions vary widely without any consensus 15–19 …”

Section: Introductionmentioning

confidence: 99%

“…Although some reports described cases of granulomatous CLE-imaging, the granuloma descriptions vary widely without any consensus. [15][16][17][18][19] Therefore, this study aimed to identify and validate nCLE granuloma criteria. Additionally, we assessed if blinded raters can make a distinction between nCLE-videos of granulomatous and malignant lung nodules.…”

Section: Introductionmentioning

confidence: 99%

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Needle‐based confocal laser endomicroscopy for real‐time granuloma detection

Kramer,

Wijmans,

van Heumen

et al. 2023

Respirology

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Background and ObjectiveNeedle‐based confocal laser endomicroscopy (nCLE) allows real‐time microscopic imaging at the needle tip. nCLE malignancy criteria are used for tool‐in‐lesion confirmation during bronchoscopic lung nodule analysis. However, to date, nCLE criteria for granulomas are lacking. The aim was to identify and validate nCLE granuloma criteria and assess if blinded raters can distinguish malignant from granulomatous nCLE videos.MethodsIn patients with suspected sarcoidosis, nCLE‐imaging of mediastinal lymph nodes was performed during endoscopic ultrasound procedures, followed by needle aspiration. nCLE granuloma criteria were identified by comparison with pathology and final diagnoses. Additionally, nCLE‐videos of granulomatous lung nodules part of prospective trials and clinical care were compared to the proposed nCLE granuloma criteria. Blinded raters validated nCLE videos of sarcoid and reactive mediastinal lymph nodes and malignant and granulomatous lung nodules twice.ResultsGranuloma criteria were identified (brighter‐toned, homogeneous and well‐demarcated lesions) based on nCLE‐imaging in 14 sarcoidosis patients. Raters evaluated 26 nCLE‐videos obtained in lymph nodes (n = 15 sarcoidosis; n = 11 reactive and total of 260 ratings). Granuloma criteria were recognized with 88% accuracy. The inter‐observer (κ = 0.63, 95% CI 0.54–0.72) and intra‐observer reliability (κ = 0.70 ± 0.06) were substantial. Based on 12 nCLE‐videos obtained in lung nodules (n = 4 granulomas, n = 6 malignancy, n = 2 malignancy + granulomas and total of 120 ratings) granuloma and malignancy criteria were recognized with 92% and 75% accuracy.ConclusionnCLE imaging facilitates real‐time granuloma visualization. Blinded raters accurately and consistently recognized granulomas on nCLE‐imaging and distinguished nCLE granuloma criteria from malignancy. Our data show the potential of nCLE as a real‐time bronchoscopic guidance tool for lung nodule analysis.

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“…Other non-invasive imaging tools and procedures have been used in ocular sarcoidosis such as conjunctiva's in vivo confocal microscopy for identifying multinucleated giant cells in patients. 33 However, as far as we know, no study has so far analyzed the relation between sarcoidosis and Meibomian glands function with meibography imaging.…”

Section: Discussionmentioning

confidence: 99%

Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

Kiyat

Palamar

Türk

2021

European Journal of Ophthalmology

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Purpose: To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Materials and Methods: Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Results: Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant ( p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 ( p = 0.047, p = 0.003, p = 0.005, respectively). Conclusion: A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

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Non-Invasive Detection of Multinucleated Giant Cells in the Conjunctiva of Patients with Sarcoidosis by In-Vivo Confocal Microscopy

Cited by 7 publications

References 5 publications

Ocular Sarcoidosis

Ocular Sarcoidosis

Needle‐based confocal laser endomicroscopy for real‐time granuloma detection

Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

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