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Recommendations for the management of ocular sarcoidosis from the International Workshop on Ocular Sarcoidosis
  1. Hiroshi Takase1,
  2. Nisha R Acharya2,
  3. Kalpana Babu3,
  4. Bahram Bodaghi4,
  5. Moncef Khairallah5,
  6. Peter J McCluskey6,
  7. Nattaporn Tesavibul7,
  8. Jennifer E Thorne8,
  9. Ilknur Tugal-Tutkun9,
  10. Joyce H Yamamoto10,
  11. Narsing A Rao11 7th IWOS Study Group,
  12. Justine R Smith12,
  13. Manabu Mochizuki1,13
  1. 1 Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
  2. 2 Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
  3. 3 Prabha Eye Clinic and Research Centre, Vittala International Institute of Ophthalmology, Bangalore, India
  4. 4 Department of Ophthalmology, IHU FOReSIGHT, Sorbonne-APHP, Paris, France
  5. 5 Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
  6. 6 Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  7. 7 Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  8. 8 Division of Ocular Immunology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, BaltimoreMD, USA
  9. 9 Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
  10. 10 Department of Ophthalmology, Faculdade de Medicina LIM-33 FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
  11. 11 USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
  12. 12 Flinders University College of Medicine and Public Health, Adelaide, SA, Australia
  13. 13 Miyata Eye Hospital, Miyakonojo, Japan
  1. Correspondence to Manabu Mochizuki, Miyata Eye Hospital, 6-3 Kurahara, Miyakonojo 885-0051, Japan; m.manabu.oph{at}tmd.ac.jp

Abstract

Aims To establish expert recommendations for the management of ocular sarcoidosis (OS).

Methods A question-based survey on the management of OS was circulated to international uveitis experts (members of the International Uveitis Study Group and the International Ocular Inflammation Society) electronically. Subsequently, a consensus workshop was conducted at the 7th International Workshop on Ocular Sarcoidosis (IWOS) in June 2019 in Sapporo, Japan as part of the Global Ocular Inflammation Workshops. Statements on the management of OS that were supported by a two-thirds majority of 10 international panel members of the workshop, after discussion and voting, were taken as consensus agreement.

Results A total of 98 participants from 29 countries responded to the questionnaire survey. The subsequent consensus workshop established recommendations for the management of OS in five sections. The first section concerned evaluation and monitoring of inflammation. The second, third and fourth sections described ocular manifestations that were indications for treatment, and the management of anterior uveitis, intermediate uveitis and posterior uveitis. In the fifth section, the use of systemic corticosteroids and systemic immunosuppressive drugs were detailed.

Conclusions Recommendations for management of OS were formulated through an IWOS consensus workshop.

  • Treatment Medical
  • Inflammation
  • Drugs
  • Diagnostic tests/Investigation
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Footnotes

  • 7th IWOS Study Group: See online supplementary appendix 1.

  • MM and JRS contributed equally to this work and share senior authorship of this manuscript.

  • Correction notice This paper has been corrected since it was published online. During the production process the production team failed to include 7th IWOS Study Group in the author list. We would like to apologise for this error.

  • Contributors MM and JRS conceived the project; designed the study; collected the questionnaire survey; designed, conducted and moderated the seventh International Workshop on Ocular Sarcoidosis on June 29, 2019 in Sapporo, Japan. HT, MM and JRS drafted the manuscript. NRA, KB, BB, MK, PJM, NT, JET, ITT, JHY and NAR reviewed and edited the manuscript draft. HT analysed the results of the questionnaire survey. MM, JRS and HT built up questionnaire survey, designed the study and reviewed the questionnaire survey. NAR made suggestions for the study. All authors and members of International Workshop on Ocular Sarcoidosis Study Group participated in the questionnaire survey and in the seventh International Workshop on Ocular Sarcoidosis on June 29, 2019 in Sapporo, Japan. All authors approved submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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