Clinical Manifestations, Complications and Treatment of Ocular Sarcoidosis: Correlation between Visual Efficiency and Macular Edema as Seen on Optical Coherence Tomography

ABSTRACT

Sarcoidosis is a chronic systemic autoimmune disease which belongs to a group of systemic granulomatous diseases. It can be confirmed through characteristic systemic and ocular manifestations and histological findings. Biopsy is the golden standard for diagnosing sarcoidosis. Ocular sarcoidosis can be confirmed, probable, or possible. Over a two-year period, ocular manifestations were studied on a sample of 52 patients, each followed for four months and diagnosed with some form of systemic sarcoidosis. Most frequent systemic manifestations in patients with ocular sarcoidosis were pulmonary, skin, glandular, and systemic generalized sarcoidosis. The disease was diagnosed four times more frequently in females than males (42:10, respectively; p < 0.05). Most frequent, and statistically significant, manifestation of ocular sarcoidosis is anterior uveitis (64.61%; p < 0.01). Macular edema and periphlebitis associated with periarteritis were frequent, and statistically significant (43.90% and 29.26%, respectively; p < 0.05). Overall, with regards to gender and location (right eye; left eye), visual acuity was >0.5 and of statistical significance (76.92%; p < 0.01). The most common therapy consisted of systemic corticosteroids (26.67%) and/or a combination of corticosteroids and immunosuppressive drugs (23.33%). In 16 eyes treated with repeated doses of sub-Tenon’s injections, both initial and control visual acuity correlated with average thickness. There was positive correlation between several optical coherence tomography findings before and after treatment.

Keywords:

• Macular edema
• ocular manifestations
• peripheral retinal laser photocoagulation
• sub-Tenon’s Triamcinolone acetonide
• systemic sarcoidosis
• treatment

ACKNOWLEDGMENT

The authors of this article would like to thank Professor Dr. Anka Stanojevic-Paovic, the chief medical officer at Uvea Center, for all of the help and support which she has provided. This work was carried out in collaboration among all authors, and all authors have read and approved the final manuscript. The authors have obtained all necessary ethical approvals and patients’ informed consent has been granted, and all authors hereby declare that all data have been examined and approved by the appropriate ethics committee and performed in accordance with the ethical standards laid out in the 1964 Declaration of Helsinki.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.