Cédric Rochepeau1,2, Yvan Jamilloux2,3, Sebastien Kerever4,5,6, Camille Febvay1,2, Laurent Perard2,7, Christiane Broussolle2,3, Carole Burillon2,8, Laurent Kodjikian1,2, Pascal Seve2,3. 1. Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 2. University Claude Bernard-Lyon 1, Villeurbanne, France. 3. Department of Internal Medicine, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 4. Department of Anesthesiology and Critical Care, St Louis-Lariboisière University Hospital, AP-HP, University Denis Diderot-Paris VII, Paris, France. 5. ECSTRA Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Centre UMR 1153, Inserm, Paris, France. 6. University of Paris VII Denis Diderot, Paris, France. 7. Department of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. 8. Department of Ophthalmology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
Abstract
AIMS: To determine the long-term visual and systemic outcomes of uveitis patients with biopsy-proven sarcoidosis. METHODS: A retrospective study of biopsy-proven sarcoid uveitis, with a 3-year minimum follow-up, seen at Lyon University Hospital, between April 2004 and January 2016. RESULTS: A total of 83 patients were included, with a median age at onset of 52 (37-62) years and an unbalanced gender ratio (women 77.1%). Thirty-one patients had original systemic sarcoidosis in addition to ocular localisation, whereas 52 initially presented with isolated sarcoid uveitis. Among the latter, 7.7% (n=4) developed an extraocular disease after a median follow-up duration of 60 (44-110) months. The systemic spread in these patients included cutaneous sarcoids (n=2), arthritis (n=1) and multiple mononeuritis (n=1). Complete visual recovery was obtained for 60.2% of all patients and 89.2% had retrieved best-corrected visual acuity (BCVA) >20/50 in both eyes. A unilateral loss of BCVA of worse than 20/200 was documented in two patients in the isolated sarcoid uveitis group. No patient suffered from bilateral severe visual impairment or blindness. Factors linked to a poor visual prognosis, defined by BCVA ≤20/50 in at least one eye, were chronic macular oedema (p=0.009) and persistent ocular inflammation (p=0.0005). CONCLUSIONS: In this large European series of biopsy-proven sarcoidosis to date, with a prolonged follow-up, sarcoid uveitis was suggestive of a favourable systemic and visual outcome. Clinically isolated uveitis that revealed sarcoidosis remained a strictly ocular condition in most cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
AIMS: To determine the long-term visual and systemic outcomes of uveitispatients with biopsy-proven sarcoidosis. METHODS: A retrospective study of biopsy-proven sarcoid uveitis, with a 3-year minimum follow-up, seen at Lyon University Hospital, between April 2004 and January 2016. RESULTS: A total of 83 patients were included, with a median age at onset of 52 (37-62) years and an unbalanced gender ratio (women 77.1%). Thirty-one patients had original systemic sarcoidosis in addition to ocular localisation, whereas 52 initially presented with isolated sarcoid uveitis. Among the latter, 7.7% (n=4) developed an extraocular disease after a median follow-up duration of 60 (44-110) months. The systemic spread in these patients included cutaneous sarcoids (n=2), arthritis (n=1) and multiple mononeuritis (n=1). Complete visual recovery was obtained for 60.2% of all patients and 89.2% had retrieved best-corrected visual acuity (BCVA) >20/50 in both eyes. A unilateral loss of BCVA of worse than 20/200 was documented in two patients in the isolated sarcoid uveitis group. No patient suffered from bilateral severe visual impairment or blindness. Factors linked to a poor visual prognosis, defined by BCVA ≤20/50 in at least one eye, were chronic macular oedema (p=0.009) and persistent ocular inflammation (p=0.0005). CONCLUSIONS: In this large European series of biopsy-proven sarcoidosis to date, with a prolonged follow-up, sarcoid uveitis was suggestive of a favourable systemic and visual outcome. Clinically isolated uveitis that revealed sarcoidosis remained a strictly ocular condition in most cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.