Directed conjunctival biopsy and impact of histologic sectioning methodology on the diagnosis of ocular sarcoidosis

Bui, Kelly M.; García-González, José María; Patel, Sarju; Lin, Amy; Edward, Deepak P.; Goldstein, Debra A.

doi:10.1186/1869-5760-4-8

Cited by 19 publications

(11 citation statements)

References 18 publications

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“…Insbesondere beim Fehlen des histopathologischen Sarkoidosenachweises aus anderen Organen kann eine Biopsie aus einem klinisch verdächtigen Bindehautareal sinnvoll sein. Die diagnostische Sensitivität der konjunktivalen Biopsie beträgt 25-50 % für Blindbiopsien aus klinisch unauffälliger Bindehaut, und bis zu 75% bei einer Biopsie aus einem verdächtigen Bindehautareal [20]. Die Bindehautbiopsie stellt eine leicht durchführbare, für den Patienten wenig invasive und sichere Methode zur Diagnosesicherung dar, es sind jedoch falsch-negative Resultate möglich [21].…”

Section: Bindehautbiopsieunclassified

“…Die Bindehautbiopsie stellt eine leicht durchführbare, für den Patienten wenig invasive und sichere Methode zur Diagnosesicherung dar, es sind jedoch falsch-negative Resultate möglich [21]. Die Sensitivität ist von der atraumatischen Gewebeentnahme und der histopathologischen Aufarbeitung abhängig, eine kleine Probe aus einem verdächtigen Areal ist oft bereits ausreichend [20].…”

Section: Bindehautbiopsieunclassified

“…Bindehautgranulome (l " Abb. 2) können klinisch sichtbar, aber auch inapparent und somit nur histologisch nachweisbar sein [20]. Eine Optikusbeteiligung kann sich als Neuritis mit oder ohne Papillitis darstellen, als Papillenödem oder als Granulombildung.…”

Section: Augenoberfläche Und Adnexeunclassified

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Augenbeteiligung bei Sarkoidose

Walscheid

Tappeiner

Heiligenhaus

2016

Klin Monatsbl Augenheilkd

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Sarcoidosis is an inflammatory multi-organ disease of unknown pathogenesis, characterised by non-necrotising granulomata. Sarcoidosis predominantly manifests in the lung, but any other organ may be affected. Ocular involvement is present in about 25 to 50 % of patients. The most common ocular manifestation is uveitis, especially of the anterior eye segment. If ocular sarcoidosis is suspected, interdisciplinary assessment of the patient is mandatory, including laboratory tests, chest X-ray, assessment by a specialist in internal medicine and, ideally, histological evidence of granuloma formation in a tissue specimen. Other (infectious) causes of granulomatous inflammation need to be excluded, especially tuberculosis or syphilis. For the ophthalmological assessment, detection of granulomatous lesions is of particular importance, especially by visualising chorioretinal granuloma by fluorescein and indocyanin green angiography. Cystoid macular oedema and glaucoma are the most frequent complications limiting visual acuity. Corticosteroids, which can be administered either locally or systemically, are the mainstay of therapy. Depending on the clinical course and the development of ocular complications, systemic steroid-sparing immunosuppressive medication may be indicated.

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Section: Bindehautbiopsieunclassified

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Augenbeteiligung bei Sarkoidose

Walscheid

Tappeiner

Heiligenhaus

2016

Klin Monatsbl Augenheilkd

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“…38 Directed conjunctival biopsies of observed lesions on examination have a reported 36% to 75% yield, and given their low morbidity, ease of obtaining, and low resources, it can be a particularly cost-effective strategy in obtaining a diagnosis. 39,40 Bronchoalveolar lavage is not often performed but can evaluate the inflammatory response, with lymphocytosis and an increased T-lymphocyte CD4/CD8 ratio seen in early disease.…”

Section: Diagnosismentioning

confidence: 99%

Ocular Sarcoidosis

Patel¹

2015

International Ophthalmology Clinics

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“…However, biopsy procedures are not acceptable for uveitis patients associated with sarcoidosis, and intraocular tissue biopsies are not generally performed because they are invasive and can result in vision loss [ 9 ]. In addition, although usefulness of conjunctival and lacrimal gland biopsies for diagnosing ocular sarcoidosis have been reported [ 10 , 11 ], these are not sensitive for sarcoidosis patients with uveitis. In 2009, the International Workshop on Ocular Sarcoidosis (IWOS) drafted a set of guidelines for characterising uveitis patients suspected of having sarcoidosis.…”

Section: Introductionmentioning

confidence: 99%

Age-related differences in the clinical features of ocular sarcoidosis

et al. 2018

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The distribution of age at diagnosis in ocular sarcoidosis has shifted towards the older age groups in developed countries. In systemic sarcoidosis, age-related differences in the clinical presentation, which reflect the therapeutic strategies, was reported. We retrospectively compared 100 consecutive patients from April 2010 to March 2016 who were initially diagnosed with ocular sarcoidosis by International Workshop on Ocular Sarcoidosis criteria. They were classified into elder (>65 years: 50 patients) and younger (≤65 years: 50 patients) groups by the age at diagnosis of uveitis associated with sarcoidosis. All patients received ophthalmic examination to assess the presence of seven intraocular signs and 4 laboratory parameters. Significantly fewer ocular signs (2.8 ± 1.5 and 3.6 ± 1.5; P = 0.0034) and abnormal laboratory results (1.5 ± 1.2 and 2.0 ± 1.2; P = 0.023) were detected in the elder group than in the younger group; statistical differences were found between the groups regarding the frequencies of mutton-fat keratic precipitates (40% and 64%; P = 0.012), vitreous opacities (60% and 78%; P = 0.0059), bilateral inflammation (64% and 80%; P = 0.012), and bilateral hilar lymphadenopathy between the groups (52% and 78%; P < 0.001). Multiple linear regression analysis showed negative correlations between age and number of detected ocular signs (r = −0.36, P < 0.001) and laboratory results (r = −0.20, P = 0.023). The characteristic ocular signs and abnormal laboratory results had a lower frequency in the elder patients compared with the younger patients. Probable or possible ocular sarcoidosis by the international criteria should increase with increased life expectancy in developed countries.

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Directed conjunctival biopsy and impact of histologic sectioning methodology on the diagnosis of ocular sarcoidosis

Cited by 19 publications

References 18 publications

Augenbeteiligung bei Sarkoidose

Augenbeteiligung bei Sarkoidose

Ocular Sarcoidosis

Age-related differences in the clinical features of ocular sarcoidosis

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