[Ocular sarcoidosis. Retrospective study of 18 cases].

PURPOSE

To assess the clinical and epidemiological characteristics, diagnostic and therapeutic methods, and the final visual outcome of a group of patients with ocular sarcoidosis.

METHODS

Retrospective study of 18 patients diagnosed of ocular sarcoidosis between March 1989 and May 1999. In every patient the following data were obtained: age, sex, bilaterality, initial and final visual outcome, systemic and ocular manifestations, stage of chest x-ray, serum markers, gallium scan, results of biopsy, medical and surgical treatment, and complications of treatment.

RESULTS

The mean age at onset was 49.7 years (S.D. 19.9). Fourteen patients (77.8%) were female and 4 (22.2%) were male. The average follow-up time was 40.3 months (S.D. 28.7). Nine patients (50.0%) underwent a biopsy. The presence of non-caseating granulomata was observed in 7 (77.8%). Gallium scanning was positive in 16 cases (88.8%). The most frequent ocular manifestation was panuveitis (40.0%). Among the 30 eyes studied, conjunctival involvement was found in 10 (33.3%), secondary cataracts in 9 (30.0%), and secondary glaucoma in 6 (20.0%). Eleven patients (61.1%) were treated with oral corticosteroids and 10 (55,5%) with cyclosporine A. When sarcoidosis was diagnosed, 11 eyes (36.6%) had a visual acuity better than 0.6. At the end of the follow-up, the final visual outcome was better than 0.6 in 17 eyes (56.6%).

CONCLUSIONS

An adequate control of ocular inflammation may improve the prognosis in patients with ocular sarcoidosis. Posterior segment involvement (posterior uveitis, macular edema or epiretinal membrane) may be associated with a worse visual prognosis.