Ocular sarcoidosis in Australia

Jessica Xiong1,2, Peter McCluskey1,2, Anthony Sammel2,3,4, Sophia S. L. Zagora1,2

Meeting:  2019 RANZCO


Date:      -

Session Title: Uveitis

Session Time:      -

Introduction: Sarcoidosis is an uncommon, but well recognised cause of uveitis in Australia. Making a definitive diagnosis of ocular sarcoidosis is often challenging. The ocular presentation is often the first presentation of the disease, leading to a systemic diagnosis. Ocular sarcoidosis accounts for approximately 5% of patients attending the uveitis unit at Sydney Eye Hospital (SEH).

Methods: We reviewed the real‐world data of clinical features, treatment and visual outcomes of patients with sarcoid related uveitis from the SEH uveitis database of more than 2050 patients seen between 2009‐2019.

Results: There were 108 patients (192 eyes) with ocular manifestations consistent of sarcoid. Using the Revised International Diagnostic criteria – 32 patients were definite (tissue diagnosis), 37 patients were presumed (abnormal CT chest) and 39 patients were probable sarcoid. The average age was 47 years (range 21‐84 years). There were more females than males. Most presentations were bilateral and chronic. The most common presentations were with anterior (38%), intermediate (28%), pan (22%) and posterior (12%) uveitis. The most common complications were cataracts (35 eyes, 18%), ↑IOP (33 eyes, 17%), CME (28 eyes, 14%) and optic neuropathy (10 eyes, 5%). Seventy‐four (69%) patients received oral prednisone and 39 (36%) had additional immunosuppressive drug therapy. Most patients maintained good vision between 6/6‐6/12‐75% at presentation and 80% at final review.

Conclusion: Sarcoid uveitis is common. Patients with ocular sarcoidosis can present with a wide range of clinical manifestations. A multidisciplinary approach is crucial for diagnosis and to achieve the best visual and systemic outcomes.