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Clinical characteristics of ocular sarcoidosis in patients with biopsy proven pulmonary sarcoidosis

Author(s):
1. Aleksandra Radosavljević, Medicinski fakultet Univerziteta u Beogradu, Klinika za očne bolesti KCS, Serbia
2. Vesna Jakšić, Medicinski fakultet Univerziteta u Beogradu, Klinika za očne bolesti KCS, 3. Aleksandra Ilić, Medicinski fakultet Univerziteta u Beogradu, Klinika za očne bolesti KCS, Serbia
4. Dijana Risimić, Medicinski fakultet Univerziteta u Beogradu, Klinika za očne bolesti KCS, Serbia


Abstract:
Purpose: To analyze the frequency and clinical characteristics of ocular sarcoidosis in a group of patients with pulmonary sarcoidosis treated in a tertiary care center. Methods: Prospective study of consecutive patients hospitalized between January 2011 and December 2014 at the single referral center for sarcoidosis in Serbia. The diagnosis of pulmonary sarcoidosis was obtained using pathohistological evaluation of tissue specimens after bronchoscopy. Ocular sarcoidosis was diagnosed based on the international criteria of the International Workshop on Ocular Sarcoidosis (2009). Results: Total of 116 consecutive patients hospitalized at Institute of Pulmonary Diseases, were examined at Uveitis Department by a single uveitis specialist. Pathohistological confirmation of pulmonary sarcoidosis was obtained in 88 patients and they were further analyzed. At exam, the majority of patients were elder adults (average age 51.2±11.2 years) and females were predominant (76%). Average duration of sarcoidosis was 5.5±7.4 years. The majority of patients had stage I and II pulmonary sarcoidosis (65% and 31%, respectively) and acute onset followed by a chronic course of the disease (51%). Sarcoid skin lesions were confirmed in 25 patients (28.4%), while peripheral lymph nodes, liver, spleen and heart lesions were less common (5.7%, 4.5%, 2.3% and 4.5% respectively). Ocular sarcoidosis was present in 32 patients (36.4%) and included eyelid skin lesions (2.3%), orbital inflammation (2.3%), conjunctival lesions (7.9%), anterior uveitis (2.3%), intermediate uveitis (1.1%), posterior uveitis (15.9%), panuveitis (5.7%) and neuroophthalmological manifestations (9.1%). Complications included cataract, glaucoma, cystoid macular edema, epiretinal membrane formation and choroidal neovascularization (in 18, 5, 3, 4, and 1 patient respectively). Binocular visual impairment due to ocular sarcoidosis was present in 1 patient (1.1%). Treatment options included steroids or immunospressives and correlated with more severe course of the disease, including cardiac sarcoidosis, neurosarcoidosis, lymph node sarcoidosis and number of relapses. Conclusion: Ocular sarcoidosis is a significant cause of non-infectious posterior uveitis. Its recurrent nature and vision-threatening potential warrant permanent patient follow-up.

Key words:
ocular sarcoidosis,sarcoid uveitis,uveitic complications

Thematic field:
Uvea

Date of abstract submission:
01.04.2017.

Conference:
Drugi kongres oftalmologa Republike Srpske sa međunarodnim učešćem

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