Purpose: To describe the spectrum of disease in sarcoid uveitis and its longterm sequelae.
Method: Cross-sectional analysis of subjects with sarcoid uveitis identified from a database of 1254 subjects with uveitis seen in the clinic of a single consultant (SL) between 2011 and 2013.
Results: 156 subjects (297 eyes) with sarcoidosis were identified, comprising 12.4% of the clinic population. Mean age at presentation was 41.6±13.8 years and 65.4% of subjects were female. Disease was bilateral in 90.4%. Intermediate uveitis was the most common presentation (45.4%) followed by panuveitis (28.2%), acute anterior uveitis (7.1%) and posterior uveitis (2.6%). Mean visual acuity at presentation was 6/9 (logMAR 0.170±0.354). The most frequent ocular manifestations were snowballs (55.6%), peripheral multifocal choroidal lesions (47.8%) and mutton fat keratic precipitates (30.0%). Cataract occurred in 37.8% and elevated intraocular pressure in 16.0%. Oral steroids were required to 59.0% of subjects and second line immunosuppression in 9.0%. Subjects were more likely to require second line immunosuppression if they were older at presentation (49.4 vs 40.9 years p=0.027) and if they had panuveitis (p=0.030). Moderate visual loss (_ 6/15) occurred in 19 eyes (6.4%) and severe visual loss (_ 6/60) occurred in 10 eyes (3.4%). Severe visual loss was more common in male subjects (p=0.030) and in subjects with nodular and/or segmental periphlebitis (p=0.022).
Conclusions: Sarcoid uveitis is a common presentation within tertiary uveitis. Most subjects are able to be controlled with topical and systemic therapy and only a small number will require second line immunosuppression.