Sarcoidosis

Abstract

Recent advances in our understanding of the immunologic events in sarcoidosis may lead to developments in treatments that would further decrease systemic and ocular morbidity.

Ocular sarcoidosis in Thailand

“…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. It is agreed that chest CT is superior and provides more details for assessing the pattern and extent of the disease compared with CXR.…”

“…It is agreed that chest CT is superior and provides more details for assessing the pattern and extent of the disease compared with CXR. 2,14,15 Possibly, the systematic making of a chest CT in patients with a clinical suspicion of sarcoidosis might reveal additional cases. However, chest CT is not recommended for the initial screening of patients with uveitis for sarcoidosis, because of its high radiation and cost.…”

“…The limited value of CXR in initial screening for uveitis was also reported in other series. 2,14,15 Future studies are needed to indicate the value of CXR in the initial screening of all patients with uveitis and to determine the exact role of chest CT in diagnostic workup of patients with uveitis and presumed sarcoidosis.…”

“…The exact cause of this disease is still unknown, although it has been suggested that genetic, environmental factors, or infectious agents may act as triggers. 1,2 Organs affected most often are the lungs, thoracic lymph nodes, skin, and eyes. Sarcoidosis affects people of all racial and ethnic groups and can occur at all ages, however, there is a great variety of incidence and prevalence throughout the world.…”

Sarcoid Uveitis

“…5 While a wide range of ocular manifestations of sarcoidosis have been reported, uveitis appears to be most common, with over 80% of patients with sarcoid uveitis having bilateral disease. [6][7][8][9][10][11][12][13][14][15][16] Definitive diagnosis of ocular sarcoidosis requires characteristic biopsy findings along with exclusion of other possible causes of ocular inflammation, particularly tuberculosis. 17,18 An International Workshop on Ocular Sarcoidosis (IWOS) met in Tokyo in October, 2006, and through consensus proposed that patients with compatible uveitis and bilateral hilar adenopathy, but no biopsy, be considered presumed ocular sarcoidosis; those with neither a biopsy nor hilar adenopathy, but at least three suggestive intraocular signs and two supportive investigational tests, be considered probable ocular sarcoidosis; and those with a negative biopsy, but at least four suggestive intraocular signs and two supportive studies be classified as possible ocular sarcoidosis.…”