目的:为了评估和比较特征,诊断,治疗,视觉预后,在法国南部的一个人群中,有或没有葡萄膜炎的眼部结节病之间的病程。
方法:我们回顾性分析了2003年1月至2021年12月在尼斯三级眼科护理中心患有眼结节病的患者的数据。纳入标准是根据IWOS标准活检证实的眼结节病,这是结节病的第一个临床表现。
结果:共纳入25例患者。20例患者患有葡萄膜炎(70%全葡萄膜炎,20%中间葡萄膜炎,和10%的前葡萄膜炎)和5例患者患有非葡萄膜性结节病(1例泪腺炎,一名眼眶肉芽肿患者,两名眼睑肉芽肿患者,和一名患有上巩膜炎的患者)。只有葡萄膜炎的病例有双侧受累(占病例的85%)。种族没有显着差异,活检诊断,系统性表现,或两组之间的治疗。两组的最终视觉结果仍然良好,96%的患者BCVA>20/50,差异无统计学意义。与葡萄膜炎患者相比,非葡萄膜结节病患者在治疗后复发少(P=0.042),缓解多(P=0.038)。80%的葡萄膜炎患者至少有三个提示临床眼内体征符合IWOS标准。
结论:在法国南部的这个人群中,葡萄膜炎是眼结节病最常见的表现。眼部结节病的类型似乎与全身表现的类型无关,使用全身治疗,或视觉预后,但非葡萄膜性眼结节病患者的病程似乎比葡萄膜性眼结节病患者更好,治疗后复发更少,缓解更多。
OBJECTIVE: To evaluate and compare characteristics, diagnosis, treatment, visual prognosis, and course between ocular sarcoidosis with or without uveitis in a population in Southern France.
METHODS: We retrospectively analyzed data from patients with ocular sarcoidosis in a tertiary eye care center in Nice from January 2003 to December 2021. The inclusion criterion was biopsy-proven ocular sarcoidosis according to IWOS criteria as the first clinical manifestation of sarcoidosis.
RESULTS: A total of 25 patients were included. Twenty patients had uveitis (70% panuveitis, 20% intermediate uveitis, and 10% anterior uveitis) and five patients had non-uveitic ocular sarcoidosis (one patient with dacryoadenitis, one patient with orbital granuloma, two patients with palpebral granuloma, and one patient with episcleritis). Only the cases with uveitis had bilateral involvement (85% of cases). There was no significant difference in ethnicity, biopsy diagnosis, systemic manifestations, or treatment between the two groups. Final visual outcomes remained good for both groups, with 96% of patients with BCVA>20/50, with no significant difference. Patients with non-uveitic sarcoidosis experienced less recurrence on treatment (P=0.042) and more remission (P=0.038) than patients with uveitis. Eighty percent of patients with uveitis had at least three suggestive clinical intraocular signs meeting IWOS criteria.
CONCLUSIONS: In this population in Southern France, uveitis was the most common presentation of ocular sarcoidosis. The type of ocular sarcoidosis does not appear to be correlated with the type of systemic manifestations, use of systemic therapy, or visual prognosis, but patients with non-uveitic ocular sarcoidosis appear to have a better course with fewer recurrences on treatment and more remission than patients with uveitic ocular sarcoidosis.