Sarcoidosis-related Uveitis: Clinical Presentation, Disease Course, and Rates of Systemic Disease Progression After Uveitis Diagnosis

Shirley, Pamela S.; Rogers, Sophie; Hall, Anthony J.; Hodgson, Lauren; Brennan, Jessica; Stawell, Richard; Lim, Lyndell L

doi:10.1016/j.ajo.2018.09.013

Cited by 49 publications

(68 citation statements)

References 27 publications

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“…2 In more recent studies of sarcoid uveitis, ophthalmological features were the initial complaints/presenting symptoms in 62.5% to 78.8% cases. 33,34 Two peaks of incidence are reported: the first one in patients aged 20 to 30 years, and the second in those aged 50 to 60 years. 31,35 There is a female predominance with a gender ratio ranging from 6.5 to 1.…”

Section: Uveitismentioning

confidence: 99%

“…31,35 There is a female predominance with a gender ratio ranging from 6.5 to 1. [28][29][30][31][34][35][36][37] Caucasian patients presented with uveitis at a later age than non-Caucasians and had more often a chronic form. 35,36…”

Section: Uveitismentioning

confidence: 99%

“…Nevertheless, recent reports from tertiary centers identified panuveitis as the most commonly encountered subtype. 34,36 Anterior Uveitis…”

Section: Uveitis Clinical Coursementioning

confidence: 99%

“…25,57 This pattern of uveitis is seen in only a minority of patients with sarcoid uveitis (6-19%). 11, 34,36,58 On the other hand, sarcoidosis is responsible for 7 to 18% of the cases of intermediate uveitis, one of the two most important systemic associations along with multiple sclerosis. 25,57 Vitreous opacities may comprise "snow-balls" and/or "string of pearls" (►Fig.…”

Section: Intermediate Uveitismentioning

confidence: 99%

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Ocular Sarcoidosis

Sève

Jamilloux

Tilikete

et al. 2020

Semin Respir Crit Care Med

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Sarcoidosis is one of the leading causes of inflammatory eye disease. Any part of the eye and its adnexal tissues can be involved. Uveitis and optic neuropathy are the main manifestations, which may require systemic treatment. Two groups of patients with sarcoid uveitis can be distinguished: one of either sex and any ethnicity in which ophthalmological findings are various and another group of elderly Caucasian women with mostly chronic posterior uveitis. Clinically isolated uveitis revealing sarcoidosis remains a strictly ocular condition in a large majority of cases. Although it can be a serious condition involving functional prognosis, early recognition in addition to a growing therapeutic arsenal (including intravitreal implant) has improved the visual prognosis of the disease in recent years. Systemic corticosteroids are indicated when uveitis does not respond to topical corticosteroids or when there is bilateral posterior involvement, especially macular edema. In up to 30% of the cases that require an unacceptable dosage of corticosteroids to maintain remission, additional immunosuppression is used, especially methotrexate. As with other forms of severe noninfectious uveitis, monoclonal antibodies against tumor necrosis factor-α have been used. However, only very rarely does sarcoid uveitis fail to respond to combined corticosteroids and methotrexate therapy, a situation that should suggest either poor adherence or another granulomatous disease. Optic neuropathy often affects women of African and Caribbean origins. Some authors recommend that patients should be treated with high-dose of corticosteroids and concurrent immunosuppression from the onset of this manifestation, which is associated with a poorer outcome.

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Section: Uveitismentioning

confidence: 99%

Section: Uveitismentioning

confidence: 99%

“…Nevertheless, recent reports from tertiary centers identified panuveitis as the most commonly encountered subtype. 34,36 Anterior Uveitis…”

Section: Uveitis Clinical Coursementioning

confidence: 99%

Section: Intermediate Uveitismentioning

confidence: 99%

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Ocular Sarcoidosis

Sève

Jamilloux

Tilikete

et al. 2020

Semin Respir Crit Care Med

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“…Sarcoidosis is an idiopathic systemic disease characterized by a noncaseating epithelioid cell granuloma lesion, and it is a major causative disease of uveitis [1]. Choroidal granuloma is a relatively rare lesion that occurs in approximately 5% of cases with uveitis lesions caused by sarcoidosis [2], whereas a large choroidal granuloma may mimic a choroidal tumor in the fundus, thus making diagnosis and treatment difficult [3].…”

Section: Introductionmentioning

confidence: 99%

A Case of Large Sarcoid Choroidal Granuloma Treated with Steroid Pulse Therapy

Kobayashi¹,

Takai²,

Sato³

et al. 2020

Case Rep Ophthalmol

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Purpose: To report a case of large sarcoid choroidal granuloma that was successfully treated with steroid pulse therapy. Case Report: A 38-year-old man presented with the primary complaint of decreased visual acuity (VA) in his left eye. Upon examination, a large white protruding lesion of 10 × 8 papilla diameter in size was observed in the macular region, and slightly temporal to it, in the patient's left eye. Whole-body contrast-enhanced computed tomography performed for differential diagnosis detected numerous enlarged lymph nodes throughout the body, including the bilateral hilar regions. Sarcoidosis was diagnosed by biopsy of the right cervical lymph nodes showing noncaseating epithelioid cell granuloma. The fundus lesion was found to be a choroidal granuloma caused by sarcoidosis, and steroid pulse therapy was started. The granuloma was considerably decreased, and the VA in the left eye improved to 0.7 after 2 months. Conclusion: Steroid pulse therapy was found to be effective as an initial treatment for a large sarcoid choroidal granuloma.

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