Sarcoidosis
1Department of Ophthalmology, hôpital Cochin, Assistance publique-Hôpitaux de Paris, université Paris Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Journal Francais D'Ophtalmologie
|November 20, 2018
Summary
Ocular sarcoidosis, an inflammatory eye condition, often presents as uveitis. Diagnosis can be challenging without systemic evidence, but treatment typically involves steroids or immunosuppressants.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Sarcoidosis is a systemic granulomatosis affecting multiple organs, commonly the lungs, skin, and eyes.
- Ophthalmological involvement occurs in 20-50% of sarcoidosis cases, often manifesting as granulomatous uveitis.
- Diagnosing ocular sarcoidosis can be difficult, especially when systemic involvement is not apparent.
Purpose of the Study:
- To review the diagnostic challenges and treatment strategies for ocular sarcoidosis.
- To highlight the typical clinical presentation of ocular sarcoidosis.
- To discuss current therapeutic options for managing ocular sarcoidosis.
Main Methods:
- Review of clinical, paraclinical, and histological findings in sarcoidosis diagnosis.
- Analysis of ophthalmological signs suggestive of ocular sarcoidosis.
- Evaluation of treatment responses to corticosteroids and immunosuppressants.
Main Results:
- Ocular sarcoidosis diagnosis often relies on clinical and histological evidence, sometimes requiring algorithms for isolated uveitis.
- Steroid-responsive uveitis is common, but corticosteroid-dependent cases necessitate further immunosuppression.
- Anti-tumor necrosis factor alpha agents offer an alternative for refractory ocular sarcoidosis.
Conclusions:
- Ocular sarcoidosis diagnosis requires a comprehensive approach, integrating systemic and ocular findings.
- Effective management of ocular sarcoidosis involves a stepwise therapeutic strategy, starting with steroids and progressing to immunosuppressants or biologics.
- Further research may elucidate the mechanisms behind isolated ocular sarcoidosis to improve diagnostic accuracy.
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