Sarcoidosis-Related Uveitis: Progression to Systemic Disease
American Journal of Ophthalmology, February 2019
Ma et al. studied the clinical course and disease characteristics of sarcoid uveitis with the goal of understanding the timing and potential risk factors of its progression to systemic sarcoidosis. They found that concurrent undiagnosed systemic sarcoidosis is common at the time of uveitis onset and recommended that clinicians maintain a high degree of suspicion for systemic disease during and after the detection of uveitis.
This study was a single-center retrospective review of records for 113 patients with concomitant uveitis and presumed (n = 69) or biopsy-proven (n = 44) sarcoidosis. Gathered data included the rate and timing of the development of symptomatic systemic sarcoidosis in relation to the onset of uveitis. The authors compared and contrasted demographics, uveitis characteristics, treatments, and visual outcomes between patients who remained systemically asymptomatic and those in whom symptomatic systemic sarcoidosis developed.
In 89 patients (79%), uveitis was the initial presenting sign of sarcoidosis. Among patients with presumed sarcoidosis, 23 had symptoms of concurrent undiagnosed systemic sarcoidosis at uveitis onset, such as a dry cough, exertional dyspnea, or erythema nodosum. Over time, symptomatic sarcoidosis developed in 29 patients in an organ that was not involved at uveitis onset. The median time from uveitis detection to the development of symptomatic systemic sarcoidosis was 12 months. All patients received topical corticosteroids for intraocular inflammation, and more than half also received regional treatment. Neither group had substantial deterioration of visual function, nor were there meaningful associations between any uveitis characteristic and the progression to extraocular sarcoidosis.
The original article can be found here.