Horst, A.I. van der (2013) Klinische kenmerken en beloop van oculaire sarcoïdose. Een vergelijking tussen patiënten suspect voor sarcoïdose en patiënten met bewezen sarcoïdose. thesis, Medicine.
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Abstract
Introduction: Sarcoidosis is a multisystem inflammatory disease that mainly affects lungs and thoracic lymph nodes. In 25-70% of patients with sarcoidosis the eyes are affected somewhere during the course of the disease. Usually this concerns uveitis. The golden standard for confirming the diagnosis sarcoidosis is biopsy from an affected organ. In clinical practice there are regularly seen patients with ophthalmic features compatible with sarcoidosis, but without extraocular manifestations of the disease and in whom no biopsy is done. The International Workshop on Ocular Sarcoidosis (IWOS) has made a list of clinical features and laboratory investigations which make the diagnosis ocular sarcoidosis more likely. Goals: - Explore whether the clinical presentation and course of uveitis in patients suspected of sarcoidosis are the same as the presentation and course in patients with proven sarcoidosis. - Gain better insight in the (long-term) prognosis of uveitis in sarcoidosis. Methods: This study was designed as a retrospective comparative cohort study of 74 patients (137 eyes), divided into a group of patients clinically suspect for sarcoidosis (22 patients, 40 eyes) and a group of patients diagnosed with sarcoidosis (52 patients, 97 eyes). Data regarding the course and severity of sarcoidosis-related uveitis, the occurrence of any secondary problems and set treatment are included in a database and analyzed. Results: Both groups did not differ significantly in terms of demographic characteristics, visual acuity and complications. Of the ophthalmic features only keratic precipitates were significantly more frequently documented in patients who were suspect for sarcoidosis (p = 0.035). The total group has a median follow-up period of almost 5 years. The median number of episodes that patients passed through is 2. 57% of all eyes passed through more than one episode of uveitis. Complications were widely seen: cataract in 28%, intra-ocular hypertension in more than 50%, glaucoma in more than 10% and cystoid macular edema in 45% of the total group. 70% of patients received systemic corticosteroids somewhere during follow-up. Conclusions: This study shows that there are no major differences between patients with ophthalmic features suspect for sarcoidosis and patients diagnosed with sarcoidosis. For clinical practice, this means that further investigation is not necessary to prove the diagnosis when the ophthalmologic features are suspect for sarcoidosis. However, it is important to carefully monitor the development of extra-ocular manifestations in patients with ocular sarcoidosis. With the results of this study patients can be informed better about the prognosis of their condition, especially about the risk of developing complications.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Los, Dr. L.I. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1198 |
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