Retrospective study of 40 cases of sarcoid uveitis

Abstract Purpose The aim of this study was to describe the clinical characteristics,the evolution and prognosis of sarcoid uveitis and to assess the best diagnostic procedure for the disease. Methods All patients with sarcoid uveitis have been seen in Caen University hospital over the last ten years. Inclusion criteria were a positive biopsy showing noncaseating granuloma or patients with a high presumption of sarcoidosis (at least 2 abnormalities amongst the main systemic diagnostic investigations). Results Biopsy was positive for 27 patients. Thoracic CT‐scan,negative tuberculin skin test, serum angiotensin converting enzyme, bronchoalveolar lavage and gallium scanning suggested the diagnosis in all other cases. Forty patients were included. There were 25 women (62%). The mean age was 43 years. The mean follow‐up duration was 55 months. Uveitis was bilateral in 29 cases. Anterior segment manifestations occured in 83% of cases,associated with a posterior segment involvement in 66% of cases. We reported a high frequency of cystoid macular oedema (CMO)(37%)and optic disc swelling(35%). The lung was the most common organ involved over the uveitis evolution period and CT‐scan was a superior imaging modality compared to chest X‐rays. Corticosteroids were the mainstay of treatment. Visual prognosis was good: mean final visual acuity was 15/20. CMO played a decisive role in poor visual outcome (p<0,05). Ocular complications were early cataract(7),epiretinal membrane(4),chronic glaucoma(3),retinal neovascularisation(1) and retinal detachment(1). Conclusion There is a high incidence of posterior involvement in sarcoid uveitis. CMO is frequent and correlated with a worse final visual acuity. Pulmonary involvement occurs in more than 90% of cases, therefore CT‐scan must always be performed.