Karadeniz, E. (2014) Systeemtherapie en visusprognose bij patiënten met oculaire sarcoïdose. thesis, Medicine.
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Abstract
Introduction: Uveitis is an inflammation of the uvea of the eye, that consists of the iris, the choroid and the ciliary body. Sarcoidosis, a chronic multisystem disease, and is the cause of uveitis in approximately 5% of the patients. The inflammation in ocular sarcoidosis could induce loss of vision. Therefore, an early adequate therapy is necessary. Corticosteroids are the most important component of therapy in both systemic and ocular sarcoidosis. If local treatment doesn’t give the desired outcome, systemic treatment in the form of oral prednisone is started. If systemic corticosteroids don’t give the expected effect or if there are side effects, steroidsparing agents can be given, like methotrexate and azathioprine. Goals: • To explore the treatment indications for the start of systemic treatment of patients with ocular sarcoidosis and of patients with uveitis which are suspected of sarcoidosis. • To gain a better insight in aspects of treatment with systemic therapy of ocular sarcoidosis. • To gain insight in the visual prognosis of uveïtis in sarcoidosis. Methods: This research was designed as a retrospective comparative cohort study of 61 patients (114 eyes), divided into a group of patients with ocular sarcoidosis (systemic group) and a group with uveïtis suspect of intraocular sarcoidosis (ocular group). Data regarding the course, set treatment, treatment indications and the vision are included in the database and analyzed. Results: Most patients had 3 uveitis episodes. The ocular group had a significant longer median follow-up time than the systemic group (8,7 and 5,1 years, respectively). The total duration of the active uveïtis in the total group was 1,0 years, with no significant difference between the groups. 78,7% of the total group received a form of systemic therapy during the study period. In the ocular group, the treatment indications were more often ophthalmic than in the systemic group. Cystoid macular edema (CME) was the most seen ophthalmic indication in both groups. CME was also significantly the most stated treatment indication in the ocular group. Of the total group, after 3 years of follow-up 65,4% of the patients had a visual acuity of ≥ 0,5. Conclusions: This study shows that CME is the most seen indication for systemic therapy of ocular sarcoidosis. It is significantly more seen in the ocular group than in the systemic group. Also in the total study population 70,9% had had an ophthalmic treatment indication, which also was significantly more seen in the ocular group than in the systemic group.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Los, Dr. L.I. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:54 |
| Last Modified: | 25 Jun 2020 10:54 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1496 |
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