Liu Dianna, Birnbaum Andrea D
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Curr Opin Ophthalmol. 2015 Nov;26(6):512-6. doi: 10.1097/ICU.0000000000000207.
Sarcoidosis is a multisystem inflammatory disease, characterized by the presence of noncaseating granulomas. Ocular inflammation is often the first manifestation of the disease, and uveitis can be the driving force for treatment. The goal of this review was to provide an update on the relationship between ocular and systemic disease, with a particular focus on cardiac sarcoidosis.
Chest radiograph remains the best imaging tool for sarcoidosis, although newer modalities, such as whole-body PET scan, cardiac MRI, and chest computed tomography (CT), may provide additional valuable information in select populations. Ocular sarcoidosis is a marker for vascular endothelial dysfunction and increased arterial rigidity. Choroidal involvement is associated with an increased risk of cardiac disease requiring intervention. Cardiac disease continues to be underdiagnosed in patients with sarcoidosis, although it remains a leading cause of death.
Sarcoidosis is a systemic disease, and ophthalmologists should continually assess patients for extraocular manifestations. Although no screening guidelines exist, baseline ECGs on asymptomatic patients might identify those at risk for adverse cardiac events. Patients with symptoms of cardiac disease, including palpitations, chest pain, and dyspnea, should have an evaluation by a cardiologist.
结节病是一种多系统炎症性疾病，其特征为存在非干酪样肉芽肿。眼部炎症常常是该疾病的首发表现，葡萄膜炎可能是治疗的驱动因素。本综述的目的是提供有关眼部与全身疾病关系的最新信息，尤其关注心脏结节病。
胸部X线片仍是结节病的最佳影像学检查手段，尽管全身PET扫描、心脏MRI和胸部计算机断层扫描（CT）等更新的检查方法可能会为特定人群提供更多有价值的信息。眼部结节病是血管内皮功能障碍和动脉僵硬度增加的一个标志。脉络膜受累与需要干预的心脏疾病风险增加相关。结节病患者的心脏疾病仍存在诊断不足的情况，尽管它仍是主要死因。
结节病是一种全身性疾病，眼科医生应持续评估患者是否有眼外表现。虽然目前尚无筛查指南，但对无症状患者进行基线心电图检查可能会识别出有不良心脏事件风险的患者。有心脏病症状（包括心悸、胸痛和呼吸困难）的患者应由心脏病专家进行评估。
