Sarcoidosis in the National Veteran Population

Abstract

Purpose To describe the distribution of ocular sarcoidosis in the veteran population and to determine the association between ocular disease and all-cause mortality. Design Retrospective review. Methods The Veterans Health Administration National Patient Care Database information on medical diagnoses, date of diagnosis, age, race, gender, and Veterans Administration medical center station number for site-specific calculations for fiscal years 2010 through 2012 was collected. Mortality data were obtained from the Beneficiary Identification Records Locator Subsystem. The patient cohort was identified with a primary diagnosis of sarcoidosis using International Classification of Disease, ninth edition, code of 135 in outpatient treatment files for the study period. The sarcoidosis patients were divided into those with uveitis or orbital inflammation (defined as ocular inflammation for this study) and those without uveitis or orbital inflammation. Survival analysis was performed using the Cox proportional hazard method. Main Outcome Measure Association between ocular inflammation and 1-year mortality. Results Of 15 130 subjects with sarcoidosis, 3364 (22.2%) were evaluated in an eye clinic within a Veterans Administration Medical Center. Most patients were diagnosed with anterior uveitis (n = 1013; 80.7% of ocular inflammation), and the least common diagnosis was orbital granuloma (n = 28; 2.2% of ocular inflammation). Male gender was protective to the development of uveitis (estimate, 0.76; 95% confidence interval, 0.65–0.88; P = 0.0005). The overall 1-year all-cause mortality for all patients with a diagnosis of sarcoidosis was 2.0%. Ocular inflammation was associated with a decrease in 1-year all-cause mortality (simple model: hazard ratio, 0.36; P = 0.0015; complex model: hazard ratio, 0.35; P = 0.013). Conclusions Veterans with ocular inflammation had significantly lower 1-year all-cause mortality than those without documented ocular inflammation. The reason for this finding remains to be established.

Annexins family: insights into their functions and potential role in pathogenesis of sarcoidosis

“…Sarcoidosis is a systemic immune disorder with a characteristic accumulation of epithelioid granulomas in many organs, such as the lungs, kidney, skin and eyes [ 50 , 51 ]. Chronic sarcoidosis is disease activity lasting more than 2 years [ 52 , 53 ].…”

<p>Ocular Manifestations of Sarcoidosis in a South Florida Population</p>

“… 6 Other studies, such as a retrospective study utilizing the national Veteran Affairs (VA) database, defined eye involvement as orbital granulomas, scleritis and uveitis, and found eye disease in 8.3% of 15,130 patients with a sarcoid diagnosis (via International Classification of Disease codes), a frequency more similar to the one seen in our study. 15 …”

“… 7 Similarly, a study of a predominantly black cohort of 63 individuals with biopsy-proven sarcoidosis in Chicago also reported a higher frequency of panuveitis among patients with sarcoid uveitis (42%, 10/24 in whites and 54%, 21/59 in blacks). 10 Other studies, however, such as a prospective study in Minnesota of a predominantly white population, 3 as well as the VA study (50% black), 15 found anterior uveitis to be the most common uveitis sub-type.…”

Ocular Manifestations of Sarcoidosis in South Florida Population

“…7 Similarly, a study of a predominantly black cohort of 63 individuals with biopsy-proven sarcoidosis in Chicago also reported a higher frequency of panuveitis among patients with sarcoid uveitis (42%, 10/24 in whites and 54%, 21/59 in blacks). 10 Other studies, however, such as a prospective study in Minnesota of a predominantly white population, 3 as well as the VA study (50% black), 15 found anterior uveitis to be the most common uveitis sub-type. The second aim of this study was to evaluate risk factors for ocular sarcoidosis.…”