From the Department of Ophthalmology, Auckland District Health Board (R.L.N., J.L.S.); Department of Ophthalmology, University of Auckland (R.L.N.), Auckland, New Zealand; Royal Victoria Eye and Ear, Melbourne, Australia (S.P.M., L.L.L.); Respiratory Services, Auckland District Health Board (M.L.W.); Faculty of Medical and Health Sciences, University of Auckland (M.L.W.), Auckland, New Zealand; Sydney Eye Hospital, Sydney, Australia (N.Q.A.); Department of Ophthalmology, Carmel Medical Centre, Technion, Haifa, Israel (O.T.-N.); University College London, London, United Kingdom (S.L.L.); and Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia (L.L.L.).
From the Department of Ophthalmology, Auckland District Health Board (R.L.N., J.L.S.); Department of Ophthalmology, University of Auckland (R.L.N.), Auckland, New Zealand; Royal Victoria Eye and Ear, Melbourne, Australia (S.P.M., L.L.L.); Respiratory Services, Auckland District Health Board (M.L.W.); Faculty of Medical and Health Sciences, University of Auckland (M.L.W.), Auckland, New Zealand; Sydney Eye Hospital, Sydney, Australia (N.Q.A.); Department of Ophthalmology, Carmel Medical Centre, Technion, Haifa, Israel (O.T.-N.); University College London, London, United Kingdom (S.L.L.); and Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia (L.L.L.).
Am J Ophthalmol. 2021 Sep;229:169-175. doi: 10.1016/j.ajo.2021.03.003. Epub 2021 Mar 15.
To examine systemic associations of sarcoid uveitis and association with uveitis clinical phenotype and ethnicity.
Retrospective cross-sectional study.
A total of 362 subjects with definite or presumed sarcoid uveitis from Moorfields Eye Hospital, Royal Victorian Eye and Ear, and Auckland District Health Board.
Data were collected from the review of clinical notes, imaging, and investigations. Sarcoidosis was diagnosed in accordance with the International Workshop on Ocular Sarcoidosis guidelines.
Diagnosis of associated systemic disease secondary to sarcoidosis.
A total of 362 subjects with sarcoid uveitis were identified. Median age was 46 years, and 226 (62.4%) were female. Granulomatous anterior uveitis (47.8%), intermediate uveitis with snowballs (46.4%), and multifocal choroiditis (43.1%) were the most frequent clinical presentations, and disease was bilateral in 313 (86.5%). Periphlebitis was observed in 21.0%, and solitary optic nerve or choroidal granuloma in 11.3%. Lung parenchymal disease was diagnosed in 200 subjects (55.2%), cutaneous sarcoid in 98 (27.1%), sarcoid arthritis in 57 (15.7%), liver involvement in 21 (5.8%), neurosarcoid in 49 (13.5%), and cardiac sarcoid in 16 subjects (4.4%). Subjects with cardiac sarcoid were less likely to have granulomatous anterior uveitis (P = .017). Caucasian subjects were older at presentation (48 vs 41 years; P = .009), had less granulomatous anterior uveitis (26.4% vs 51.7%; P < .001), and were less likely to present with cutaneous involvement (23.1% vs 35.4%; P = .040).
Ophthalmologists need to be aware of the systemic associations of sarcoid uveitis, in particular potentially life-threatening complications such as cardiac sarcoidosis. Differences observed in uveitis phenotype and between ethnicities require further investigation.
研究结节病性葡萄膜炎的全身关联，并探讨其与葡萄膜炎临床表型和种族的关系。
回顾性横断面研究。
来自 Moorfields 眼科医院、皇家维多利亚眼耳医院和奥克兰地区卫生局的 362 例明确或疑似结节病性葡萄膜炎患者。
通过对临床记录、影像学和检查结果的回顾收集数据。结节病的诊断符合国际眼结节病工作组的标准。
继发于结节病的系统性疾病的诊断。
共发现 362 例结节病性葡萄膜炎患者。中位年龄为 46 岁，226 例（62.4%）为女性。最常见的临床表现为肉芽肿性前葡萄膜炎（47.8%）、伴有雪球状混浊的中间葡萄膜炎（46.4%）和多灶性脉络膜炎（43.1%），313 例（86.5%）为双眼受累。21.0%患者出现睫状体周围炎，11.3%患者出现孤立性视神经或脉络膜肉芽肿。200 例（55.2%）患者诊断为肺实质疾病，98 例（27.1%）为皮肤结节病，57 例（15.7%）为结节病关节炎，21 例（5.8%）为肝脏受累，49 例（13.5%）为神经结节病，16 例（4.4%）为心脏结节病。心脏结节病患者更不可能出现肉芽肿性前葡萄膜炎（P =.017）。白种人患者的发病年龄更大（48 岁比 41 岁；P =.009），肉芽肿性前葡萄膜炎的发生率更低（26.4%比 51.7%；P <.001），且皮肤受累的发生率更低（23.1%比 35.4%；P =.040）。
眼科医生需要了解结节病性葡萄膜炎的全身关联，特别是潜在的危及生命的并发症，如心脏结节病。观察到的葡萄膜炎表型和不同种族之间的差异需要进一步研究。
