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Identification of Multidimensional Phenotypes Using Cluster Analysis in Sarcoid Uveitis Patients
Cécile Fermon1, Thomas El-Jammal2, Laurent Kodjikian3
1From the Department of Internal Medicine, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1 (C.F.), Lyon; Laboratoire UMR-CNRS 5303: Laboratory of Tissue Biology and Therapeutic Engineering, Institute of Biology and Protein Chemistry (C.F., T.E.-J.), Lyon; Lyon Immunology FEderation (LIFE) (C.F., Y.J.), Lyon; University Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290 (C.F., P.S.), Lyon, France.
This study identified three distinct patient phenotypes for sarcoid uveitis, each with unique characteristics, treatment responses, and visual prognoses. Understanding these sarcoidosis uveitis phenotypes is crucial for tailored patient management.
Area of Science:
- Ophthalmology
- Immunology
- Systemic Autoimmune Diseases
Background:
- Sarcoid uveitis is an inflammatory eye condition often associated with systemic sarcoidosis.
- Accurate patient phenotyping is essential for predicting disease course and treatment outcomes.
Purpose of the Study:
- To identify and characterize distinct multidimensional phenotypes of patients with sarcoid uveitis.
- To understand the clinical heterogeneity within sarcoid uveitis.
Main Methods:
- Retrospective cohort study of 299 sarcoid uveitis patients (December 2003-December 2020).
- Hierarchical cluster analysis was performed on clinical data, including demographics, uveitis characteristics, systemic manifestations, treatments, and outcomes.
- Sarcoidosis and uveitis were diagnosed using established criteria (Abad's modified criteria and Standardization of Uveitis Nomenclature).
Main Results:
- Three distinct sarcoid uveitis phenotypes were identified.
- Cluster 1: Younger, non-Caucasian patients with acute, anterior uveitis, systemic involvement, and good visual recovery.
- Cluster 2 & 3: Middle-aged Caucasian patients with chronic or mixed uveitis patterns, varying systemic involvement, and poorer visual prognoses, with differences in treatment intensity and outcomes.
Conclusions:
- The study suggests the existence of multiple sarcoid uveitis phenotypes with varying clinical trajectories and prognoses.
- These findings highlight the importance of recognizing patient heterogeneity in sarcoid uveitis.
- Further research into genetic and environmental factors is warranted to explain these observed phenotypes.
