1
|
Kuč S, Wijnen P, Erckens R, Gijs M, Webers CAB, Bekers O, Drent M. Clinical Patterns of Sarcoidosis Patients with and without Uveitis: Insights from a Dutch Sarcoidosis Centre. Ocul Immunol Inflamm 2024:1-8. [PMID: 38916581 DOI: 10.1080/09273948.2024.2369931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/15/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Uveitis is a common ocular manifestation in individuals with sarcoidosis, a multisystem inflammatory disorder. This study aimed to explore clinical and genetic factors associated with the presence or absence of uveitis in sarcoidosis patients. METHODS Total 625 Dutch sarcoidosis patients were included. Among these, 170 underwent ophthalmic examination, and 61 were diagnosed with uveitis. Demographic and clinical data, including age, gender, race, biopsy status, chest radiography findings, TNF-α inhibitor treatment, and uveitis classification were collected retrospectively from medical records. Genetic data was available for HLA haplotypes, TNF-α G-308A, and BTNL2 G16071A polymorphisms. RESULTS The majority of the patients presented with bilateral uveitis (80.3%). The proportion of women was higher in the uveitis group compared to the non-uveitis group (67.2% and 47.7%; p = 0.014). Pulmonary involvement (chest radiographic stage II-III) was significantly lower in patients with uveitis (36.1% versus 64.2%; p < 0.001). Patients with uveitis were more often treated with TNF-α inhibitors (67.2% versus 29.4%; p < 0.001) and the outcome was better compared with the non-uveitis group, 92% vs 68%, responders (p < 0.012). Uveitis patients treated with TNF-α inhibitors (either adalimumab or infliximab) were more likely to suffer from intermediate or posterior uveitis than anterior uveitis. Genetic analysis identified a significant association between the BTNL2 G16071A GG genotype and uveitis (p = 0.012). CONCLUSION This study highlights distinctive demographic, clinical and genetic features associated with uveitis in sarcoidosis patients. Ocular sarcoidosis was more prevalent in women. Further research is warranted to explore the implications of these findings for treatment strategies and prognostic assessments.
Collapse
Affiliation(s)
- Sanela Kuč
- University Eye Clinic, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Petal Wijnen
- Interstitial Lung Disease (ILD) Care Foundation, Research Team, Ede, The Netherlands
- Department of Clinical Chemistry, Central Diagnostic Laboratory, MUMC, Maastricht, The Netherlands
| | - Roel Erckens
- University Eye Clinic, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Marlies Gijs
- University Eye Clinic, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Carroll A B Webers
- University Eye Clinic, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Otto Bekers
- Department of Clinical Chemistry, Central Diagnostic Laboratory, MUMC, Maastricht, The Netherlands
| | - Marjolein Drent
- Interstitial Lung Disease (ILD) Care Foundation, Research Team, Ede, The Netherlands
- ILD Center of Excellence, Department of Respiratory Medicine, Nieuwegein, The Netherlands
- Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
2
|
Chabchoub I, Damak C, Bouhamed M, Rekik M, Abid C, Frikha F, Kammoun S, Jemaa YB, Marzouk S, Bahloul Z. Central retinal vein occlusion : an uncommon complication in sarcoidosis. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2024; 62:82-87. [PMID: 37851995 DOI: 10.2478/rjim-2023-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Indexed: 10/20/2023]
Abstract
Sarcoidosis is a multi-system granulomatosis of unknown etiology, defined by the presence of epithelioid and gigantocellular granulomas, without caseous necrosis. Ocular sarcoidosis manifests mainly as bilateral granulomatous anterior uveitis. Occlusion of the central retinal vein in sarcoidosis is a rare manifestation, which is the particularity of our observation. We report the case of a patient presenting with unilateral central retinal vein occlusion associated with granulomatous anterior uveitis on the same side. Systemic manifestations and further investigations led to the diagnosis of sarcoidosis.
Collapse
Affiliation(s)
- Imen Chabchoub
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Chifa Damak
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Marwa Bouhamed
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mouna Rekik
- Ophthalmology Department, Habib Bourguiba Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Cyrine Abid
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Faten Frikha
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Sonda Kammoun
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Yoldez Ben Jemaa
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sameh Marzouk
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| | - Zouhir Bahloul
- Department of Internal Medicine, Hédi Chaker Hospital, University of Sfax Faculty of Medicine 3029 Sfax, Tunisia
| |
Collapse
|
3
|
Kemer Atik B, Altan C, Yargı Özkoçak B, Basarir B. Clinical Features and Course in Patients Diagnosed with Ocular Sarcoidosis without Previously Known Systemic Disease at a Tertiary Referral Center in Turkey. Ocul Immunol Inflamm 2024; 32:168-174. [PMID: 37756621 DOI: 10.1080/09273948.2023.2258397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE To evaluate the ocular features, course, and prognosis of uveitis in the ocular sarcoidosis (OS) subgroups without previously known systemic sarcoidosis. METHODS Ninety-one eyes of 49 patients were included. Definite OS patients were classified as group 1 (n = 15), presumed OS patients as group 2 (n = 15), and probable OS patients as group 3 (n = 19). RESULTS The most common presentation of OS was panuveitis in all groups. During the follow-up, bilateral ocular involvement was observed in 85.7% of the patients. The most common extraocular involvement was pulmonary involvement, which was detected in 61.2% of the patients at the time of diagnosis. CONCLUSION Ophthalmologists should be aware that uveitis may be the first sign of systemic sarcoidosis. In all subgroups of OS, uveitis tends to be bilateral and the most common type is panuveitis. Therefore, the eye without obvious clinical findings should be carefully evaluated clinically and angiographically.
Collapse
Affiliation(s)
- Burcu Kemer Atik
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Berru Yargı Özkoçak
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Berna Basarir
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
4
|
Yalcinsoy KO, Erol YO, Hondur G, Ozdal PC. Quantitative evaluation of retinal and choroidal microcirculation in inactive ocular sarcoidosis. Indian J Ophthalmol 2023; 71:3367-3374. [PMID: 37787237 PMCID: PMC10683694 DOI: 10.4103/ijo.ijo_3262_22] [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] [Received: 12/15/2022] [Revised: 04/29/2023] [Accepted: 06/10/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose To evaluate retinal and choroidal alterations in eyes with inactive ocular sarcoidosis and to compare the findings with healthy controls. Methods This cross-sectional study included 11 patients with inactive ocular sarcoidosis (study group) and 11 healthy individuals (control group). Retinal and choroidal vascular differences were evaluated using optical coherence tomography angiography (OCTA) and enhanced depth imaging-optical coherence tomography (EDI-OCT). Results A total of 21 eyes of ocular sarcoidosis patients without active inflammation and 22 eyes of healthy controls were analyzed. The mean whole-image deep capillary plexus vessel density was significantly lower in the study group than in the control group (P = 0.03). The acircularity index values were significantly higher, and the foveal density-300 values were significantly lower in the study group than in the control group (P = 0.01, both). The flow areas of the choriocapillaris at 1-, 2-, and 3-mm radius areas were also significantly lower in the study group (all P < 0.01). The mean choroidal thickness (CT) was significantly lower in all regions between nasal and temporal at 3000 μm in the study group (all P < 0.05). The choroidal vascularity index (CVI) values were also significantly lower in the study group (P < 0.01). Conclusion Ocular sarcoidosis was associated with a reduction in CT and the CVI with a decrease in retinal vessel density and choriocapillary flow parameters. The combination of OCTA and EDI-OCT imaging may be useful in monitoring ocular sarcoidosis eyes to detect alterations in the retinal and choroidal layers.
Collapse
Affiliation(s)
- Kubra Ozdemir Yalcinsoy
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Yasemin Ozdamar Erol
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Gozde Hondur
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Pinar Cakar Ozdal
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
5
|
Flores JLR, de Ceballos EPG, Hernández-Cruz B, Muñoz AHA, Machuca-Aguado J, Gallardo SR, Venegas JJP. Refractory multisystemic sarcoidosis, a diagnosis and treatment challenge: a case report. J Med Case Rep 2023; 17:303. [PMID: 37386509 DOI: 10.1186/s13256-023-03996-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 05/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Sarcoidosis is a multisystemic granulomatous disease of unknown origin. It is characterized by abnormal activation of lymphocytes and macrophages with the formation of granulomas. Most cases have asymptomatic pulmonary involvement. In case of symptoms, they have an excellent response to glucocorticoid therapy. We present a case of sarcoidosis with multi-organ involvement, refractory to multiple treatments including biological. Partial remission was achieved in it. CASE PRESENTATION We report an interesting case of a 38-years-old Spanish woman treated by Heerfordt's syndrome (uveitis, parotiditis, fever and facial palsy) plus pulmonary hiliar adenopathy. A sarcoidosis diagnosis was confirmed by lung biopsy. She was initially treated with an 8 weeks course of medium dose oral glucocorticoids and tapered over 8 weeks with improvement. After the suspension of glucocorticoids a relapse occurs with severe ocular involvement and suspicion of neurological involvement. The patient received multiple lines of treatment with poor response. Finally, after the combination of cyclophosphamide with infliximab, the uveitis resolved, improving the neurological symptoms. CONCLUSIONS Sarcoidosis is a benign disease in most cases. In a small percentage of cases behaves aggressively, requiring early diagnosis and immunosuppressive treatment to avoid sequelae. An adequate immunosuppressive therapy based on Anti TNF drugs should be started to minimize damage and improve the quality of life.The choice of treatment depends on the type and severity of the disease.
Collapse
Affiliation(s)
- Jorge Luis Rodas Flores
- Rheumatology Department, Virgen Macarena University Hospital, Av Dr. Fedriani 3, 41009, Seville, Spain.
| | | | - Blanca Hernández-Cruz
- Rheumatology Department, Virgen Macarena University Hospital, Av Dr. Fedriani 3, 41009, Seville, Spain
| | | | - Jesús Machuca-Aguado
- Pathological Anatomy Department, Virgen Macarena University Hospital, Av Dr. Fedriani 3, 41009, Seville, Spain
| | - Salvador Recio Gallardo
- Radiology Department, Virgen Macarena University Hospital, Av Dr. Fedriani 3, 41009, Seville, Spain
| | - José Javier Perez Venegas
- Rheumatology Department, Virgen Macarena University Hospital, Av Dr. Fedriani 3, 41009, Seville, Spain
| |
Collapse
|
6
|
Eser-Ozturk H, Izci Duran T, Aydog O, Sullu Y. Sarcoid-like Uveitis with or without Tubulointerstitial Nephritis during COVID-19. Ocul Immunol Inflamm 2023; 31:483-490. [PMID: 35201954 DOI: 10.1080/09273948.2022.2032195] [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] [Received: 07/19/2021] [Revised: 12/05/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To report sarcoid-like uveitis with or without tubulointerstitial nephritis (TIN) during coronavirus disease 2019 (COVID-19) and to discuss diagnostic evaluation and treatment. METHODS Detailed information on the subject's demographics, medical history, ophthalmic examination findings, and laboratory results were obtained from medical records. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) images were evaluated. RESULTS All seven patients aged between 8 and 17 had bilateral granulomatous panuveitis. TIN preceded in four patients. Thorax computed tomography of patient 1 was found to be compatible with COVID-19, patients 2 and 3 were in contact with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive parents, patients 4 and 5 were found to be SARS-CoV-2 PCR positive, and patients 6 and 7 were positive for SARS-CoV-2 IgG antibodies. ICGA revealed hypofluorescent dots in six patients. Intraocular inflammation was controlled with corticosteroid and/or immunomodulatory therapy. Visual acuity was maintained or improved in all. CONCLUSION SARS-CoV-2 infection may be related to sarcoid-like uveitis and acute tubulointerstitial nephritis.
Collapse
Affiliation(s)
- Hilal Eser-Ozturk
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
| | - Tugba Izci Duran
- Department of Internal Medicine, Division of Rheumatology, Ondokuz Mayıs University, Samsun, Turkey
| | - Ozlem Aydog
- Department of Pediatric Nephrology, Ondokuz Mayıs University, Samsun, Turkey
| | - Yuksel Sullu
- Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
7
|
Fernández-Ramón R, Gaitán-Valdizán JJ, González-Mazón I, Sánchez-Bilbao L, Martín-Varillas JL, Martínez-López D, Demetrio-Pablo R, González-Vela MC, Ferraz-Amaro I, Castañeda S, González-Gay MA, Blanco R. Systemic treatment in sarcoidosis: Experience over two decades. Eur J Intern Med 2023; 108:60-67. [PMID: 36446677 DOI: 10.1016/j.ejim.2022.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the frequency of systemic treatment in a cohort of sarcoidosis patients and identify presenting clinical features as predictive factors of the need for systemic immunosuppressive therapy. METHODS Retrospective study of 342 patients diagnosed and followed-up from January 1999 to December 2019 in a University Hospital in Northern Spain. The diagnosis of sarcoidosis was established according to ATS/ERS/WASOG criteria. A comparative analysis was performed between treated and untreated patients. Predictive factors of treatment prescription according to initial clinical manifestations were identified (multivariate analysis). RESULTS Mean age at diagnosis was 47.7±15.1 years, with a slight female predominance (51.8%) and Caucasian majority (94.2%). The main clinical manifestation was thoracic involvement (88.3%). Extrathoracic manifestations were detected in 68.4% cases, mainly cutaneous (34.2%), articular (27.8%) and ocular (17.8%). A total of 207 (60.5%) patients required systemic treatment. Glucocorticoid therapy was the most widely used (60.5%). Conventional immunosuppressive therapy in 25.4%, more frequently MTX (21.9%). Biologic therapy was prescribed in 12.9%, especially adalimumab (9.1%). Male gender (OR: 1.65; 95%CI: 1.06-2.56), intrathoracic (OR: 2.41; 95%CI: 1.22-4.76), ocular (OR: 4.14; 95%CI: 2.01-8.52), parotid (OR: 1.60; 95%CI: 1.39-1.94), neurological (OR: 5.00; 95%CI: 1.68-14.84), and renal (OR: 1.59; 95%CI: 1.38-1.94) involvement were identified as risk factors associated with the need of systemic treatment. CONCLUSION Most patients (60.5%) of sarcoidosis in our series required systemic therapy. An association between certain characteristics at initial presentation (male gender, lung, ocular, parotid, neurological and renal involvement) and the need of systemic treatment was identified.
Collapse
Affiliation(s)
- Raúl Fernández-Ramón
- Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Iñigo González-Mazón
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Lara Sánchez-Bilbao
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - David Martínez-López
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Rosalía Demetrio-Pablo
- Department of Ophthalmology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M Carmen González-Vela
- Department of Pathology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Iván Ferraz-Amaro
- Department of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Santos Castañeda
- Department of Rheumatology, Hospital Universitario de La Princesa, Madrid; Cátedra UAM-Roche, EPID-Future, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Miguel A González-Gay
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Ricardo Blanco
- Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
| |
Collapse
|
8
|
Shen J, Su Z, Feng L. Sarcoid uveitis: A case report and systematic review of literature. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100047. [PMID: 37846382 PMCID: PMC10577835 DOI: 10.1016/j.aopr.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/20/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2023]
Affiliation(s)
- Junhui Shen
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, China
| | - Zhitao Su
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, China
| | - Lei Feng
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, China
| |
Collapse
|
9
|
Abstract
AIM To document atypical presenting forms of ocular sarcoidosis at the corneal level. METHODS Case report. RESULTS A 63-year-old woman presented multiple uncommon unilateral primary corneal conditions as manifestation of ocular sarcoidosis, including peripheral ulcerative keratitis, sterile corneal infiltrate (corneal granuloma), and sterile infiltrates related to a corneal foreign body, requiring medical and surgical management to control the inflammatory symptoms and to preserve the integrity of the eyeball. An excisional biopsy of a nodule in the temporal conjunctiva was performed under topical anesthesia. Histological analysis revealed a non-caseating granuloma, confirming the diagnosis of ocular sarcoidosis. CONCLUSION When thinking of ocular involvement in patients with ocular sarcoidosis, it is essential to remember that manifestations such as peripheral ulcerative keratitis, sterile corneal infiltrate, and sterile foreign body-related infiltrates may be presentations of this disease.
Collapse
Affiliation(s)
- Andrea Córdoba
- Cornea Service, Ophthalmology Department, School of Medicine, CES University, Medellin, Colombia
| | - Luis F Mejía
- Cornea Service, Ophthalmology Department, School of Medicine, CES University, Medellin, Colombia
| | - Natalia González
- Ophthalmology Department, School of Medicine, CES University, Medellin, Colombia
| | - Juan C Gil
- Cornea Service, Ophthalmology Department, School of Medicine, CES University, Medellin, Colombia
| |
Collapse
|
10
|
Conti MLD, Osaki MH, Sant'Anna AE, Osaki TH. Orbitopalpebral and ocular sarcoidosis: what does the ophthalmologist need to know. Br J Ophthalmol 2021; 106:156-164. [PMID: 33622698 DOI: 10.1136/bjophthalmol-2020-317423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 12/17/2022]
Abstract
Sarcoidosis is a chronic multisystemic disease of unknown aetiology, characterised by non-caseating granulomas. Ocular involvement rate ranges from 30% to 60% among individuals with sarcoidosis, and can vary widely, making the diagnosis a challenge to the ophthalmologist. Cutaneous manifestations occur in about 22% of sarcoidosis cases, but eyelid involvement is rare. Eyelid swelling and nodules are the most frequent forms of eyelid involvement, but other findings have been reported. The joint analysis of clinical history, ancillary exams and compatible biopsy is needed for the diagnosis, as well as the exclusion of other possible conditions. This review aims to describe the different forms of presentations, the clinical reasoning and treatment options for ocular, eyelid and orbital sarcoidosis.
Collapse
Affiliation(s)
- Marina Lourenço De Conti
- Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, Paulista School of Medicine / Federal University of S. Paulo - EPM / UNIFESP, S. Paulo, SP, Brazil
| | - Midori Hentona Osaki
- Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, Paulista School of Medicine / Federal University of S. Paulo - EPM / UNIFESP, S. Paulo, SP, Brazil.,Ophthalmology, Osaki Ophthalmology, S. Paulo, SP, Brazil
| | - Ana Estela Sant'Anna
- Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, Paulista School of Medicine / Federal University of S. Paulo - EPM / UNIFESP, S. Paulo, SP, Brazil
| | - Tammy Hentona Osaki
- Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, Paulista School of Medicine / Federal University of S. Paulo - EPM / UNIFESP, S. Paulo, SP, Brazil .,Ophthalmology, Osaki Ophthalmology, S. Paulo, SP, Brazil
| |
Collapse
|