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Rosenbaum JT, Pasadhika S. Ocular Sarcoidosis. Clin Chest Med 2024; 45:59-70. [PMID: 38245371 DOI: 10.1016/j.ccm.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Sarcoidosis frequently affects the eye and can do so in many different ways. Sarcoidosis causing uveitis can have distinctive features that facilitate identifying sarcoidosis as the cause of the uveitis. Progress is being made in elucidating ocular sarcoidosis, as for example, by transcriptomics, genetics, therapy, and imaging.
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Affiliation(s)
- James T Rosenbaum
- Legacy Devers Eye Institute, 1040 NW 22nd Avenue, Portland, OR 97210, USA; Corvus Pharmaceuticals, 863 Mitten Road Street 102, Burlingame, CA 94010, USA.
| | - Sirichai Pasadhika
- Legacy Devers Eye Institute, 1040 NW 22nd Avenue, Portland, OR 97210, USA
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Bolletta E, De Simone L, Pellegrini M, Preziosa C, Mastrofilippo V, Adani C, Gentile P, Gozzi F, Cimino L. Optical Coherence Tomography in Inflammatory and Neoplastic Lesions Deforming the Choroidal Profile. Diagnostics (Basel) 2023; 13:1991. [PMID: 37370886 DOI: 10.3390/diagnostics13121991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
The choroid is the main part of the uvea, the vascular layer of the eye that lies between the retina and the sclera. The high vascular component of the choroid makes this structure susceptible to inflammation in multisystemic diseases, as well as the most common site of metastasis in the eye. Therefore, the choroid is involved in many pathological conditions, from uveitis to intraocular tumors. Differentiating between inflammatory and neoplastic lesions deforming the choroidal profile can sometimes be challenging. In addition, scleral disorders can also deform the choroidal profile. Choroidal imaging includes ophthalmic ultrasonography, indocyanine green angiography, and optical coherence tomography (OCT). Recent advances in choroidal imaging techniques, such as enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source optical coherence tomography (SS-OCT), have facilitated an in-depth analysis of the choroid. The purpose of this review article is to report on and highlight the most common OCT findings to help in the differential diagnosis between inflammatory and neoplastic lesions deforming the choroidal profile.
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Affiliation(s)
- Elena Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Marco Pellegrini
- Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Chiara Preziosa
- Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | | | - Chantal Adani
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Pietro Gentile
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
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Giorgiutti S, Jacquot R, El Jammal T, Bert A, Jamilloux Y, Kodjikian L, Sève P. Sarcoidosis-Related Uveitis: A Review. J Clin Med 2023; 12:jcm12093194. [PMID: 37176633 PMCID: PMC10178951 DOI: 10.3390/jcm12093194] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Sarcoidosis is an inflammatory disease that involves the eyes in 10-55% of cases, sometimes without systemic involvement. All eye structures can be affected, but uveitis is the most common ocular manifestation and causes vision loss. The typical ophthalmological appearance of these uveitis is granulomatous (in cases with anterior involvement), which are usually bilateral and with synechiae. Posterior involvement includes vitritis, vasculitis and choroidal lesions. Tuberculosis is a classic differential diagnosis to be wary of, especially in people who have spent time in endemic areas. The diagnosis is based on histology with the presence of non-caseating epithelioid granulomas. However, due to the technical difficulty and yield of biopsies, the diagnosis of ocular sarcoidosis is often based on clinico-radiological features. The international criteria for the diagnosis of ocular sarcoidosis have recently been revised. Corticosteroids remain the first-line treatment for sarcoidosis, but up to 30% of patients require high doses, justifying the use of corticosteroid-sparing treatments. In these cases, immunosuppressive treatments such as methotrexate may be introduced. More recent biotherapies such as anti-TNF are also very effective (as they are in other non-infectious uveitis etiologies).
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Affiliation(s)
- Stéphane Giorgiutti
- Department of Clinical Immunology and Internal Medicine, National Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, 67000 Strasbourg, France
- INSERM UMR-S1109, Université de Strasbourg, 67000 Strasbourg, France
| | - Robin Jacquot
- Department of Internal Medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- Faculté de Médecine et de Maïeutique Lyon-Sud-Charles Mérieux, Université de Lyon, 69000 Lyon, France
| | - Thomas El Jammal
- Department of Internal Medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- Faculté de Médecine et de Maïeutique Lyon-Sud-Charles Mérieux, Université de Lyon, 69000 Lyon, France
- Laboratory of Tissue Biology and Therapeutic Engineering, CNRS UMR5305, IBCP, University of Lyon, 69007 Lyon, France
| | - Arthur Bert
- Department of Internal Medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- Faculté de Médecine et de Maïeutique Lyon-Sud-Charles Mérieux, Université de Lyon, 69000 Lyon, France
| | - Yvan Jamilloux
- Department of Internal Medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- Faculté de Médecine et de Maïeutique Lyon-Sud-Charles Mérieux, Université de Lyon, 69000 Lyon, France
| | - Laurent Kodjikian
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- UMR5510 MATEIS, CNRS, INSA Lyon, Université de Lyon 1, 69100 Villeurbanne, France
| | - Pascal Sève
- Department of Internal Medicine, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69004 Lyon, France
- Faculté de Médecine et de Maïeutique Lyon-Sud-Charles Mérieux, Université de Lyon, 69000 Lyon, France
- Pôle IMER, Hospices Civils de Lyon, 69002 Lyon, France
- The Health Services and Performance Research (EA 7425 HESPER), Université de Lyon, 69003 Lyon, France
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