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[Ocular sarcoidosis: What the internist should know?]
P Sève1, L Kodjikian2, Y Jamilloux1
1Service de médecine interne, université de Lyon, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
La Revue De Medecine Interne
|October 18, 2017
Summary
Sarcoidosis commonly causes inflammatory eye disease, including uveitis and optic neuropathy. Early recognition and new treatments like intravitreal implants are improving visual outcomes for patients with ocular sarcoidosis.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Sarcoidosis is a leading cause of inflammatory eye disease, affecting various ocular and adnexal tissues.
- Uveitis and optic neuropathy are the primary ocular manifestations encountered by internists.
Purpose of the Study:
- To review current knowledge on ocular sarcoidosis, specifically uveitis and optic neuropathy.
- To propose an assessment algorithm for diagnosing sarcoidosis in patients with suspected sarcoid uveitis.
Main Methods:
- Review of existing literature on ocular sarcoidosis.
- Analysis of patient demographics and clinical presentations.
- Discussion of current and emerging therapeutic strategies.
Main Results:
- Two distinct patient groups for sarcoid uveitis: young, multiethnic with varied findings, and elderly Caucasian women with chronic posterior uveitis.
- Clinically isolated uveitis is often the sole manifestation of sarcoidosis.
- Improved visual prognosis due to early recognition and advanced therapies, including intravitreal implants.
Conclusions:
- Ocular sarcoidosis requires prompt diagnosis and management.
- Systemic corticosteroids and immunosuppressants are crucial for refractory cases.
- Biologics like infliximab and adalimumab show promise for severe or sight-threatening disease.