Clinical profile of presumed and definitive ocular sarcoidosis

Introduction. Sarcoidosis is an antigen-mediated disease of unknown cause defined by granulomatous inflammation of different organs. Objective. The aim of this study was to analyze the clinical picture in 26 patients with a definitive and presumed ocular sarcoidosis. Methods. The following tests were conducted: angiotensin-converting enzyme, tuberculin skin test, liver enzymes and calcium in urine and serum. Enlarged hilar lymph glands were diagnosed using X-ray tomography or computed tomography of the mediastinum. A biopsy of lymph glands was performed either transbronchially or transmediastinally. Ophthalmic examination included biomicroscopic examination, intraocular pressure measurement, photofundus, fluorescein angiography, optical coherence tomography and computerized perimetry. Results. The average follow-up period of the disease was 6.1 years. The average age was 52.0 years. There were 62.5% female patients, with bilateral incidence of 69.2%. The clinical picture included: panuveitis (in 30.8% of patients), anterior uveitis (26.9%), posterior uveitis (26.9%), intermediate uveitis (7.7%) and vitritis in (7.7%). The following complications were observed: cataract (in 34.6% of patients), cystoid macular edema (23.1%), glaucoma (15.4%), macroaneurysms (15.4%), neovascularization (7.7%) and band keratopathy (3.8%). There was a statistically significant difference in the visual acuity (p=0.033) and severity of clinical symptoms (p=0.02) between the groups of patients with retinal vasculitis associated with “candle-wax” phenomenon and the group of patients with multiple chorioretinal lesions - “white dot” syndrome. Conclusion. To our consideration, the differences observed between the two groups are the result of retinal vasculitis and subsequent macular edema, which is significantly more frequent in the group with “candle-wax” phenomenon.