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Long-term visual and systemic prognoses of 83 cases of biopsy-proven sarcoid uveitis
  1. Cédric Rochepeau1,2,
  2. Yvan Jamilloux2,3,
  3. Sebastien Kerever4,5,6,
  4. Camille Febvay1,2,
  5. Laurent Perard2,7,
  6. Christiane Broussolle2,3,
  7. Carole Burillon2,8,
  8. Laurent Kodjikian1,2,
  9. Pascal Seve2,3
  1. 1Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
  2. 2University Claude Bernard-Lyon 1, Villeurbanne, France
  3. 3Department of Internal Medicine, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
  4. 4Department of Anesthesiology and Critical Care, St Louis—Lariboisière University Hospital, AP-HP, University Denis Diderot—Paris VII, Paris, France
  5. 5ECSTRA Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Centre UMR 1153, Inserm, Paris, France
  6. 6University of Paris VII Denis Diderot, Paris, France
  7. 7Department of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
  8. 8Department of Ophthalmology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
  1. Correspondence to Professor Pascal Seve, Département de Médecine Interne, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, Lyon 69004, France; pascal.seve{at}chu-lyon.fr

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.

  • Inflammation
  • Epidemiology

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Footnotes

  • Contributors CR, CF, LK, LP, YJ, ChB, CaB and PS collected the data. CR, LK, SK, LP, YJ, ChB, CaB and PS performed the statistical analyses and interpreted the data. CR, LK, SK, LP, JI, YJ, ChB, CaB and PS drafted and revised the manuscript. All authors have read and approved the final version.

  • Competing interests None.

  • Ethics approval The institutional review board of Hospices Civils de Lyon gave its approval to review retrospectively the records of patients seen at two departments of Internal Medicine and two departments of ophthalmology at Lyon University Hospitals between April 2004 and January 2016.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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