Clinical features and visual outcomes of ocular sarcoidosis at a tertiary referral center in Tokyo

Nagahori, Katsuya; Keino, Hiroshi; Nakayama, Makiko; Watanabe, Takayo; Ando, Yoshimasa; Hayashi, Isami; Abe, Shinya; Okada, Annabelle A.

doi:10.1007/s00417-022-05701-x

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…34 These findings were also corroborated by separate studies done in Tokyo and Taiwan which found that ocular complications were observed in upto 85%, most commonly cataract (50.8-73%), epiretinal membrane (24%), macular edema (24%) and glaucoma (19-25.4%) and also posterior synechiae(20.5%). 15,16 In this study, the most frequent complication was raised IOP(18 eyes-39.13%) with documented Secondary angle closure glaucoma in four eyes(8.6%). Although hypotony and the consequent hypotony maculopathy was the cause of decreased vision in only four eyes in this study, it was among the most common vision limiting complications.…”

Section: Original Research Articlementioning

confidence: 50%

“…In a study done between 2013 to 2018 at the Kyorin eye center, Tokyo, among eyes of 53 patients with sarcoid uveitis, the best-corrected visual acuity was 1.0 or better (Snellen's equivalent-6/60) in 51% of eyes at presentation, 57% at six months, 50% at 12 months, and 58% at 36 months. 15 In another study done in Taiwan, a total of 122 eyes of 66 patients (13 males and 53 females) with ocular sarcoidosis (OS) were identified. Forty-three eyes (36.1%) and 74 eyes (62.2%) had a final vision of 20/20 and 20/40 or better, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Visual outcome of standard treatment of sarcoid uveitis at a tertiary eye center in Nepal

et al. 2023

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Introduction: Sarcoidosis is a less-studied disease in Nepal, both as a systemic as well as ocular disease. We aimed to describe the visual outcome of standard therapy of sarcoid uveitis in Nepal. Methods: Observational study through Electronic Medical recording system of Tilganga Institute of Ophthalmology from December 2017 to March 2020. Patients diagnosed by IWOS criteria, treated with standard protocol and with minimum six-month follow up were included. The clinical parameters evaluated were type of uveitis, anatomical location and IWOS category. Treatment related factors evaluated were need for immunosuppressants, anti-glaucoma medication and cataract surgery. Visual outcome at six months was the major outcome evaluated, considering two lines of improvement or worsening as significant. Vision limiting complications assessed were cystoid macular edema, complicated cataract and secondary glaucoma. Visual outcome was stratified based on demography, anatomical involvement, uveitis subtype, IWOS category and need for immunomodulators. Results: Forty-six eyes of 25 patients were included. Based on IWOS criteria, presumed ocular sarcoidosis had best visual outcome with 93.33% improvement. Males had better post-treatment vision (90% vs.76.9%). 20-40 years age group had best improvement (96.5%) and anterior uveitis had best visual outcome (100%). A single immunomodulator could not be recommended based on this study. 18(39%) eyes had raised IOP, 4(8.6%) had secondary angle closure glaucoma, 4(8.6%) had hypotony, 1(2.1%) eye underwent cataract surgery and 1(2.1%) eye had cystoid macular edema. Conclusions: Sarcoid uveitis has good visual outcome. High degree of suspicion, early diagnosis and prompt treatment aids in diagnosis and limits vision-limiting complications.

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Section: Original Research Articlementioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Visual outcome of standard treatment of sarcoid uveitis at a tertiary eye center in Nepal

et al. 2023

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“…Fewer than 10% of patients have severe visual impairment, defined as visual acuity below 20/200 [37,38,125,126]. Complications of ocular inflammation are very frequent, in particular cataracts, which affect up to 73% of patients depending on the study [124,127]. In the report by Suzuki et al, cataract occurred in 62.2% of cases, glaucoma in 28.5%, epiretinal membrane in 24.1% and cystoid macular edema in 22.6% [124].…”

Section: Visual Prognosis Of Sarcoid Uveitismentioning

confidence: 99%

Sarcoidosis-Related Uveitis: A Review

Giorgiutti

Jacquot

Jammal

et al. 2023

JCM

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Sarcoidosis is an inflammatory disease that involves the eyes in 10–55% of cases, sometimes without systemic involvement. All eye structures can be affected, but uveitis is the most common ocular manifestation and causes vision loss. The typical ophthalmological appearance of these uveitis is granulomatous (in cases with anterior involvement), which are usually bilateral and with synechiae. Posterior involvement includes vitritis, vasculitis and choroidal lesions. Tuberculosis is a classic differential diagnosis to be wary of, especially in people who have spent time in endemic areas. The diagnosis is based on histology with the presence of non-caseating epithelioid granulomas. However, due to the technical difficulty and yield of biopsies, the diagnosis of ocular sarcoidosis is often based on clinico-radiological features. The international criteria for the diagnosis of ocular sarcoidosis have recently been revised. Corticosteroids remain the first-line treatment for sarcoidosis, but up to 30% of patients require high doses, justifying the use of corticosteroid-sparing treatments. In these cases, immunosuppressive treatments such as methotrexate may be introduced. More recent biotherapies such as anti-TNF are also very effective (as they are in other non-infectious uveitis etiologies).

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“…"Diagnosed ocular sarcoidosis" was defined as uveitis with features meeting the IWOS criteria for ocular sarcoidosis, and "suspected ocular sarcoidosis" was defined as idiopathic uveitis with at least 3 of 7 IWOS ocular clinical signs suggestive of ocular sarcoidosis but not meeting the criteria for ocular sarcoidosis [8]. The IWOS intraocular findings suggesting ocular sarcoidosis are as follows: (1) mutton-fat keratic precipitates and/or iris nodules, (2) tent-shaped peripheral anterior synechia and/or trabecular meshwork nodules, (3) vitreous opacities (snowballs/string-of-pearls), (4) multiple chorioretinal peripheral lesions (active or atrophic), ( 5) segmental or nodular periphlebitis and/or macroaneurysm, (6) optic disc nodule(s)/granuloma(s) and/or solitary choroidal nodule, and ( 7) bilaterality [7,25].…”

Section: Subjectsmentioning

confidence: 99%

Comparative Analysis of Serum microRNA in Diagnosed Ocular Sarcoidosis versus Idiopathic Uveitis with Ocular Manifestations of Sarcoidosis

Saito

Keino

Takasaki

et al. 2022

IJMS

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“Idiopathic” is the most common category of uveitis, representing cases in which a specific diagnosis has not been established despite work-up. Sarcoidosis is a systemic granulomatous disorder affecting multiple organs including the lungs, skin, kidneys, and eyes. We used microRNA (miRNA) microarrays to investigate serum miRNA profiles of patients with ocular sarcoidosis as diagnosed by specific criteria (diagnosed ocular sarcoidosis), and patients with idiopathic uveitis characterized by ocular manifestations of sarcoidosis (suspected ocular sarcoidosis). Principal component analysis (PCA) and hierarchical clustering showed that serum miRNA profiles of diagnosed ocular sarcoidosis and suspected ocular sarcoidosis were both clearly distinguishable from healthy controls. Furthermore, comparative analysis of the miRNA profiles showed highly similar patterns between diagnosed ocular sarcoidosis and suspected ocular sarcoidosis. Pathway analysis revealed common pathways were involved in the two groups, including those of WNT signaling and TGF-beta signaling. Our study demonstrated a high overlap of differentially expressed serum miRNAs in patients with diagnosed ocular sarcoidosis and suspected ocular sarcoidosis, suggesting that these groups share a similar underlying pathology and may represent possible variants of the disease. Characterization of serum miRNA profiles may provide an opportunity for earlier diagnosis and treatment, and may inform more accurate clinical prognosis in patients with an ocular sarcoidosis phenotype.

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Clinical features and visual outcomes of ocular sarcoidosis at a tertiary referral center in Tokyo

Cited by 5 publications

References 31 publications

Visual outcome of standard treatment of sarcoid uveitis at a tertiary eye center in Nepal

Visual outcome of standard treatment of sarcoid uveitis at a tertiary eye center in Nepal

Sarcoidosis-Related Uveitis: A Review

Comparative Analysis of Serum microRNA in Diagnosed Ocular Sarcoidosis versus Idiopathic Uveitis with Ocular Manifestations of Sarcoidosis

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