Tattoo-Associated Sarcoid-like Uveitis: A Multicenter Registry Study

Background: This study aims to characterize the clinical features and outcomes of tattoo-associated sarcoid-like uveitis using a multicenter uveitis registry given the limited existing data. Design: This is a retrospective study. Participants: Ten patients (20 eyes) diagnosed with tattoo-associated sarcoid-like uveitis took part in the study. Methods: The data of patients newly evaluated at participating registry centers from January 2000 to June 2025 were reviewed. Demographic data, treatments, visual acuity, recurrence, glaucoma/intraocular pressure (IOP)-lowering therapy, extraocular involvement, and histologic confirmation were extracted when available. Main Outcome Measures: Recurrence, glaucoma/IOP-lowering therapy, extraocular involvement, and change in logarithm of the minimum angle of resolution (logMAR) from presentation to final follow-up were measured. Results: Seven (70%) patients were male, and the patients' mean age was 35.1 ± 7.8 years. All patients exhibited bilateral ocular involvement. Histologic confirmation at the tattoo site was documented in five (50%) patients. The mean logMAR visual acuity was 0.12 ± 0.31 at presentation and 0.16 ± 0.42 at the final follow-up (median follow-up: 20 months). All patients received topical corticosteroids; periocular steroids were administered in seven cases (70%), oral systemic steroids in four (40%), adalimumab in two (20%), and cyclosporin in one (10%). Seven cases (70%) developed uveitis recurrence, and eight received glaucoma/IOP-lowering therapy (80%). Extraocular inflammation affected the skin/tattoo in seven patients (70%) and the axillary lymph nodes in one (10%). This finding is definitive; however, this is also true even when the organ/body part is plural (e.g., lungs). Conclusions: Tattoo-associated sarcoid-like uveitis often follows a chronic course with frequent recurrence and uveitic glaucoma. Thus, close ophthalmic monitoring and coordinated systemic evaluation may be warranted.