Clinical Profile, Management and Visual Outcomes in Patients with Sarcoid Posterior Uveitis

To determine the demographic profile, clinical features, investigative results, management, lesion-specific outcomes, complications and follow-up of diagnosed sarcoid posterior uveitis (SPU) cases, presenting at a single tertiary care hospital.

A retrospective observational study was carried out. Details of all SPU cases were extracted from electronic medical records of a tertiary care center in India.

Seventy-two eyes (of 43 patients) were included, of which 31 were bilateral SPU. Mean age of patients was 41.7 ± 13.0 years and 55.8% were females. The most common lesion noted was choroidal granulomas (62%). The mean presenting BCVA was-0.35 ± 0.5 logMAR which varied across lesion subtypes. Steroid was the mainstay of treatment and 90% cases were also started on immunosuppressives (IMT). Fifty-two eyes were followed up for 6 months. BCVA was stable in 75%, improved in 15.4% & declined in 9.6%. Lesion-specific visual prognosis and clinical response to treatment were analysed. Clinical response to treatment and visual acuity outcomes were noted to be better in retinal vasculitis and choroidal granulomas as opposed to eyes with multifocal choroiditis.

Sarcoid posterior uveitis is associated with a significant visual morbidity. Early identification of cause and manifestations are imperative. Timely treatment with steroids and IMT can cause resolution of uveitis and improvement in vision. The visual prognosis and response to treatment depend on lesion subtype of SPU.