K 416
Intraocular findings and diagnostic in 38 patients with histological confirmed systemic sarcoidosis in Germany
A. Hassenstein, V. Knospe, G. Richard
Introduction: Intraocular findings in sarcoidosis were described by US-studies with 35% anterior uveitis, 25% posterior uveitis and 20-30% for late complications in case of first presentation. We report on the spectrum and diagnostic possibilities in 38 german patients.
Patients: 38 patients (68 eyes) at the age of 11-58 years (average 42.7 y), who suffered of intraocular manifestations in histological confirmed systemic sarcoidosis (1987-1997), were completely evaluated retrospectively.
Results: 15 patients (22 eyes) (=32.4%) showed an anterior uveitis: granulomatous keratouveitis 10 eyes, granulomas of the iris 6, granulomas of the trabecular meshwork 3 eyes, and 22 patients (42 eyes)(61.8%) an intermediate and posterior uveitis: granulomatous perivasculitis 18 eyes, cystoid maculopathy 8, pars planitis 6, neuroretinitis 4, optic neuritis 3, choroiditis 3 eyes. Late complications in case of first presentation were found in 22 patients (39eyes)(57.4%): posterior synechiae 14x, secondary glaucoma 10x, cataracta complicata 8x, optic atrophy 6x, intraocular calcification 1x. For additional diagnostic tools fluorescein angiography, optical coherence tomography, nuclear magnetic resonance tomography and measurement of angiotensin-converting-enzyme and calcium in serum were performed.
Discussion: In contrast to US-epidemiologic studies with heterogenous ethnic composition, intraocular inflammations with confirmed sarcoidosis in German patients show more than 60% intermediate and posterior uveitis. Any additional diagnostic tool will be discussed.
University Eye Hospital Hamburg, Eppendorf, Martinistr. 52, D-20251 Hamburg, Germany