Contribution of Ocular Involvement to the Diagnosis of Systemic Sarcoidosis and Prognostic Significance

Only a few studies have analyzed the diagnostic utility and prognostic significance of ocular sarcoidosis (OS) in patients with systemic sarcoidosis. Our aim was to analyze the prevalence of OS in sarcoidosis, its possible association with other forms of extrathoracic sarcoidosis, and its prognostic significance.

Retrospective study including patients diagnosed with sarcoidosis at Bellvitge University Hospital, Barcelona, Spain, between 1980 and 2017. Patients were prospectively followed up at the hospital's sarcoidosis clinic. Clinical data were obtained by reviewing patients' medical records.

Sarcoidosis was diagnosed in 728 patients (494 women and 234 men, mean age 43.45 years, SD 13.833). Radiological stages were: stage 0 in 68 patients (9.34%), 1 in 434 (59.62%), 2 in 167 (22.94%), 3 in 45 (6.18%), and 4 in 14 (1.92%). OS was diagnosed in 98/728 patients (13.5%) and was present at the onset of sarcoidosis in 83 cases (85%). Among patients with OS, 42/98 (42.9%) had persistent systemic sarcoidosis activity for more than 5 years (p < 0.001), and 21/98 (21.4%) had central nervous system sarcoidosis (p < 0.001). Patients with OS also showed a higher frequency of otorhinolaryngological involvement (12.2% vs. 2.2%, p < 0.001) and specific skin lesions (30.61% vs. 20.8%, p = 0.036), while erythema nodosum and arthralgia were less frequent (p < 0.001 and p = 0.001, respectively).

OS was observed in 13.5% of sarcoidosis patients, usually at the onset of the disease. It was associated with systemic disease activity persisting for more than 5 years and with central nervous system sarcoidosis.