Clinical Patterns of Sarcoidosis Patients with and without Uveitis: Insights from a Dutch Sarcoidosis Centre

Figures & data

Figure 1. Flowchart of the selection of sarcoidosis patients with an ophthalmic examination, with and without uveitis.

Table 1. Characteristics of the sarcoidosis patients with and without uveitis.

	Uveitis	No uveitis	p-value
Number	61	109	NA
Age at diagnosis (years, mean ± SD)	45 ± 16	41 ± 10	NA
Gender
Female	41 (67.2)	52 (47.7)	0.014
Male	20 (32.8)	57 (52.3)
Race
Caucasian	55 (90.2)	104 (95.4)	NA
Black	3 (4.9)	3 (2.8)
Asian	1 (1.6)	0
Other	2 (3.3)	2 (1.8)
Biopsy
Yes	23 (37.7)	87 (79.8)	<0.001
No	38 (62.3)	22 (20.2)
CXR at diagnosis
0	24 (39.3)	7 (6.4)	NA
I	15 (24.6)	32 (29.4)
II	16 (26.2)	47 (43.1)
III	6 (9.9)	23 (21.1)
No pulmonary involvement (0+I)	39 (63.9)	39 (35.8)	<0.001
Pulmonary involvement (II+III)	22 (36.1)	70 (64.2)
TNF-α inhibitor treatment (adalimumab or infliximab)
Yes	41 (67.2)	32 (29.4)	<0.001
No	20 (32.8)	77 (70.6)
Skin and/or joint involvement
Yes	46 (75.4)	88 (80.7)	0.42
No	15 (24.6)	21 (19.3)

Data are expressed as total number with percentage in parentheses, or mean ±SD if appropriate.

Bold indicates significance.

Abbreviations: CXR = chest radiography; NA = not applicable; TNF = tumour necrosis factor.

Table 2. Characteristics of uveitis patients with or without tumour necrosis factor (TNF) alpha inhibitor treatment.

	Uveitis patients
	Total group	Treated with TNF-α inhibitors	Not treated with TNF-α inhibitors	p-value
Number	61	41 (67.2)	20 (32.8)	NA
Age at diagnosis (years)	45 ± 16	43 ± 13	51 ± 20	NA
Gender
Female	41 (67.2)	29 (70.7)	12 (60.0)	0.56
Male	20 (32.8)	12 (29.3)	8 (40.0)
Classification of uveitis according to SUN criteria
Anterior	12 (19.7)	4 (9.8)	8 (40.0)	NA
Anterior and intermediate	9 (14.8)	6 (14.6)	3 (15.0)
Intermediate	21 (34.4)	19 (46.3)	2 (10.0)
Intermediate and posterior	1 (1.6)	1 (2.4)	0 (0)
Posterior	15 (24.6)	9 (22.0)	6 (30.0)
Panuveitis	3 (4.9)	2 (4.9)	1 (5.0)
Anterior	12 (19.7)	4 (9.8)	8 (40.0)	0.008
All other uveitis	49 (80.3)	37 (90.2)	12 (60.0)
Laterality
Unilateral	12 (19.7)	6 (14.6)	6 (30.0)	0.18
Bilateral	49 (80.3)	35 (85.4)	14 (70.0)
Macular oedema	20 (32.8)	14 (34.1)	6 (30.0)	0.78
Vasculitis	11 (18.0)	8 (19.5)	3 (15.0)	0.74
Papillitis	18 (29.5)	14 (34.1)	4 (20.0)	0.37
CXR at diagnosis
0+I	39 (63.9)	25 (61.0)	14 (70.0)	0.58
II+III	22 (36.1)	16 (39.0)	6 (30.0)
Initially seen by
Ophthalmologist	25 (41.0)	14 (34.1)	11 (55.0)	0.17
Pulmonologist	36 (59.0)	27 (65.9)	9 (45.0)
Systemic treatment
Prednisone	36 (59.0)	28 (68.3)	8 (40.0)	0.052
Prednisone without MTX	9 (14.6)	3 (7.3)	6 (30.0)	0.028
MTX	37 (60.7)	35 (85.4)	2 (10.0)	<0.0001
AZA	3 (4.9)	3 (7.3)	0 (0)	NA
Cellcept	2 (3.3)	2 (4.9)	0 (0)	NA
TNF-α inhibitors
Adalimumab	29 (47.5)	29 (70.7)	0 (0)	NA
Infliximab	12 (19.7)	12 (29.3)	0 (0)	NA

Data are expressed as total number with percentage in parentheses, or mean ± SD if appropriate.

Bold indicates significance.

Abbreviations: CXR=chest radiography; NA=not applicable; SUN=standardization of uveitis; MTX=methotrexate; AZA=azathioprine.

Figure 2. Fundus images of both eyes of a 32-year-old female sarcoidosis patient with bilateral panuveitis. The black arrows indicate snowballs, the white arrows indicate multiple atrophic chorioretinal lesions.

OS= oculus sinister (left eye), OD=oculus dexter (right eye).

Figure 3. Fluorescein angiogram of both eyes of the same sarcoidosis patient with bilateral panuveitis. The black arrows indicate vascular leakage, the white arrows indicate hyperfluorescent dots corresponding to multiple atrophic chorioretinal lesions.

Table 3. Some relevant polymorphisms in sarcoidosis patients with and without uveitis.

	Sarcoidosis patients with uveitis	Sarcoidosis patients without uveitis	p-value
Number	61	109	NA
HLA DRB1*03
Negative	46 (75.4)	78 (71.6)	0.53
Positive	12 (19.7)	26 (23.9)
missing	3 (4.9)	5 (4.6)
HLA DRB1*15
Negative	44 (72.1)	69 (63.3)	0.21
Positive	14 (23.0)	35 (32.1)
missing	3 (4.9)	5 (4.6)
BTNL2 G16071A
GG	11 (18.0)	7 (6.4)	0.012
GA/AA	41 (67.2)	91 (83.5)
missing	9 (14.8)	11 (10.1)
TNF-α G-308A
GG	45 (73.8)	71 (65.1)	0.25
GA/AA	16 (26.2)	38 (34.9)
missing	0	0

Data are expressed as total number with percentage in parentheses, or mean ±SD if appropriate. Bold indicates significance.

Abbreviations: DRB1= D-related beta chain 1 of human leukocyte antigen class II; BTNL2 = butyrophilin-like 2; NA = not applicable; TNF-α = tumour necrosis factor alpha, GG = wild type variant; GA = heterozygous variant; AA = homozygous variant.