Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
Miyata Eye Hospital, Miyakonojo, Japan.
Br J Ophthalmol. 2019 Oct;103(10):1418-1422. doi: 10.1136/bjophthalmol-2018-313356. Epub 2019 Feb 23.
International criteria for the diagnosis of ocular sarcoidosis (OS) was established by the first International Workshop on Ocular Sarcoidosis (IWOS) and validations studies revealed certain limitations of the criteria. To overcome the limitations, revised IWOS criteria was established in an international meeting. This manuscript was aimed at reporting the revised IWOS criteria.
A consensus workshop was carried out to discuss and revise the IWOS criteria. The workshop was held on 27 April 2017, in Nusa Dua, Bali, Indonesia. Prior to the workshop, a questionnaire proposing revised criteria and consisting of one item for differential diagnosis, seven items for ocular clinical signs, 10 items for systemic investigations and three categories of diagnostic criteria was circulated to 30 uveitis specialists. Questionnaire items with over 75% support were taken as consensus agreement; items with below 50% support were taken as consensus disagreement and items with 50%-75% support were discussed at the workshop. Of the latter items, those supported by two-thirds majority in the workshop were taken as consensus agreement.
The survey and subsequent workshop reached consensus agreements of the revised criteria for the diagnosis of OS as follows: (1) other causes of granulomatous uveitis must be ruled out; (2) seven intraocular clinical signs suggestive of OS; (3) eight results of systemic investigations in suspected OS and (4) three categories of diagnostic criteria depending on biopsy results and combination of intraocular signs and results of systemic investigations.
Revised IWOS criteria were proposed by a consensus workshop.
国际眼部结节病(OS)诊断标准由第一届国际眼部结节病研讨会(IWOS)制定,验证研究显示该标准存在一定局限性。为克服这些局限性,在一次国际会议上制定了修订后的 IWOS 标准。本文旨在报告修订后的 IWOS 标准。
为了讨论和修订 IWOS 标准,召开了一次共识研讨会。该研讨会于 2017 年 4 月 27 日在印度尼西亚巴厘岛努沙杜瓦举行。在研讨会之前,向 30 名葡萄膜炎专家分发了一份包含修订标准的问卷,其中包括一个鉴别诊断项目、七个眼部临床体征项目、十个系统检查项目和三个诊断标准类别。得到超过 75%支持的问卷项目被视为共识协议;得到低于 50%支持的项目被视为共识分歧,而得到 50%-75%支持的项目则在研讨会上进行了讨论。在后者中,三分之二多数人支持的项目被视为共识协议。
该调查和随后的研讨会就 OS 诊断修订标准达成了如下共识协议:(1)必须排除其他肉芽肿性葡萄膜炎的病因;(2)七个提示 OS 的眼内临床体征;(3)疑似 OS 的八项系统检查结果和(4)取决于活检结果以及眼内体征和系统检查结果组合的三种诊断标准类别。
修订后的 IWOS 标准是通过共识研讨会提出的。