References

Czech and Slovak Ophthalmology

Original article

Sarcoidosis and its ocular manifestations (an analysis of six case reports)

Sokačová

Petra

Krásný

Jan

https://orcid.org/0000-0002-0341-0094

Kozák

Jiří

Srp

Antonín

Šach

Josef

https://orcid.org/0000-0001-9287-7915

Tomášová Borovanská

Jitka

Votava

Vladimír

30 1 2018

5+6

Aim: To introduce the range of eye changes in sarcoidosis in the individual casuistics. Materials: At the Ophthalmic Clinic of Teaching Hospital Královské Vinohrady in Prague were examined and treated six patients with ocular forms of sarcoidosis in the years from 1998 to 2015. Three patients were unilateral lesions of the lacrimal gland without systemic symptoms. One patient experienced orbital inflammatory syndrome that accompanied the hilar form of pulmonar sarcoidosis. Two other patients underwent intraocular inflammation, panuveitis / iridocyclitis and bilateral intermedial uveitis. Both of these patients also had systemic affections of mediastinal lymph nodes and lung, in the first of these, signs of neurosarcoidosis first appeared. Results: In the treatment of lacrimal glands, the diagnosis was determined by histological examination of the removed lacrimal gland in external orbitotomies, also, the orbital process has been verified by biopsy and the subsequent comprehensive examination revealed the systemic process. Definitive diagnosis of sarcoidosis was established bioptically in both uveitides and has also been demonstrated in imaging methodologies including galli scintigraphy. All patients were successfully treatedwith corticosteroid therapy. Conclusion: Biopsy results have always been a surprise in orbital processes. Both cases of uveitis were associated with systemic involvement and initiated comprehensive investigation which showed the need for interdisciplinary collaboration in the diagnosis and treatment of sarcoidosis.

sarkoidosis biopsy corticosteroids gallii scintigraphy MRI uveitis

References

Achille, M., Ilaria, P., Teresa, G., et al.: Successful Treatment with Adalimumab for Severe Multifocal Chorioiditis and Panuveitis in Presumed (Early-onset) Ocular Sarcoidosis. Int Ophthalmol, 36, 2016: 129–135.

Anton, M., Pluhoš, M., Riebel, O.: Izo - lovaný sarkoid slzné žlázy. Čs Oftal, 15, 1959: 375–379.

Babu, K., Shukla, S.B., Philips, M.: High Resolution Chest Computerized Tomography in the Diagnosis of Ocular Sarcoidosis in a High TB Endemic Population. Ocul Immunol Inflamm, 23, 2016: 1–6.

Baughman, R.P., Lower E.E., Ingledue, R., Kaufman, A.H.: Management of Ocular Sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis, 1, 2012: 26–33.

Bezo, C., Maizoub, S., Nochez, Y., et al.: Ocular and Neuro-ophthalmic Manifestation of Sarcoidosis: Retrospective Study of 30 Cases. J Fr Ophthalmol, 36, 2013: 473–480.

Borovanská, J., Krásný, J., Šach., J., et al: Granulomatózní zánět orbity – sarkoidóza, Sborník abstrakt z XI. výročního sjezdu ČOS, Hradec Králové, 2003, s. 84.

Čepilová, Z., Porubská, M., Fabianová, J.: Sarkoidóza – kazuistika. Čes a Slov Oftal, 64, 2008: 34–37.

Dolinová, L.: Postižení spojivky a odvodných slzných cest sarkoidózou. Čs Oftal. 33, 1977: 443–446.

Doycheva, D., Deuter, C., Stuebiger, N., Zierhut, M.: Interferon-alfa-associated Presumed Ocular Sarcoidosis. Graefes Arch. Clin. Exp. Ophthalmol. 247, 2009: 675 – 680.

Engelhard, S.B., Patel, V., Reddy, A.K.: Intermediate Uveitis, Posterior Uveitis and Panuveitis in the Mid-Atlantic USA. Clin Ophthalmol, 9, 2025: 1549–1555.

Goto, H., Usui, Z., Umazume, A., et al.: Proprionibacterium Acne as a Possi - ble Pathogen of Granuloma in Patients with Ocular Sarcoidosis. Br J Ophthalmol, 111, 2017: doi: 1136/bjothalmol-2016-309248.

Hainovici, R., Foster, C.S.: Sarkoidosis, In. Pepose J.S., Holland G.N., Wilhelmus K.R.: Ocular Infection and Immunity, Mosby, St. Louis, 1996, p. 754–776.

Hanušová, H.: Oční projevy sarkoidózy v dětském věku, Čs. oftal.: 44, 1988: 212 – 215.

Havlíková, M., Říhová, E., Kopřivová, J. et al: Oční projevy sarkoidózy, Čs. oftal., 1994: 367–370.

Heissigereová, J., Říhová, E., Svozílková, P., et al.: Uveitidy u neinfekčních systémových onemocněních. Abstrakta Den uveitid, 2010, JS Parner s.r.o., s. 11, ISBM 978-80-87036-50-1.

Herbort, C.P., Rao, N.A, Mochizuki, M., et al.: 23 Collaborated Members of Soc. Com. of 1 st Internat. Workshop on Ocular Sarcoidosis: International Criteria for the Diagnosis of Ocular Sarcoidosis: Results of the 1 st International Workshop on Ocular Sarcoidosis, Ocular Immunol. Inflamm., 17, 2009: 160–169.

Kang, J.J., Aakalu, V.K., Lin, A., Sebtabutr. P.: Orbital Granuloma Annulare as Presentation of Systematic Sarcoidosis. Orbit, 32, 2013: 372–374.

Kolek, V. Sarkoidóza. Známé a neznámé. Praha: Avicenum, 1998, 239 s.

Konidaris, V.E., Empeslidis, T.: Ranibi - zumab in Choroidal Neovascularisation Associated with Ocular Sarcoidosis. BMJ Case Rep. 2013, doi: 10.136/bcr-2013- 010288.

Krásný, J., Šach, J., Brunnerová, R., et al.: Orbitální tumory u dospělých – desetiletá studie, Čes a Slov Oftal, 64, 2008: 219–217.

Mayer, G.N., Longo, M., Gomes B.B. Nobrega, M.J.: Low Dose Corticosteroid in Association wih Methotrexate for Therapy of Ocular Sarcoidosis. Report of a Case. Int. J. Retina Vitreous. 1, 2015: doi: 10.1186/s40942-0215-0006-7.10.1186/s40942-0215-0006-7

Menezo, V., Lobo, A., Yeo, T.K., et al.: Ocular Features in Neurosarcoidosis. Ocul Immunol Inglamm, 17, 2009: 170– 178.

Otradovec, J.: Choroby očnice, Avice - num, Praha, 1986, s. 177 – 178.

Pasadhika, S., Rosenbaum, J.T.: Ocular Sarcoidosis. Clin,. Chest Med. 36, 2015: 669 – 683.

Petrarolha, S.M., Rodrigues, B.S., Filho, F.D. et al.: Unilateral Eyelid Edema as Initial Sign of Orbital Sarcoidosis. Case Rep Ophthalmol Med, 2016, doi:1.1155/2016/6912927.

Riancho-Zarrabeitia, L., Calvo-Rio, V., Blanco, R., et al.: Anti-TNF-alfa Therapy in Refractory Uveitis Associated with Sarcoidosis: Multicenter Study of 17 Patients. Semin Arthris Rheum, 45, 2015: 361–368.

Rochepeau, P., Jamilloux, Y., Kerever, S., et al.: Long-term Visual and Systemic Prognoses of 83 Cases of Biopsy-proven Sarcoid Uveitis. Br J Ophthalmol, 110, 2016, doi: 10.1136/bjophthalmol-2016-309762.10.1136/bjophthalmol-2016-309762

Říhová, E. et al.: Uveitidy. Grada, Praha, 2009, s. 75 77.

Sokačová, P., Šach., J., Krásný, J.: Klinické rozhraní problematiky sarkoidózy, Abstrakta Den uveitid, 2012, JS Parner s.r.o, s. 8, ISBM 978-80-87036-61-7.

Spalton D.J., Sanders M.D.: Fundus Changes in Histologically Confirmed Sarcoidosis, Br. J. Ophtalmol., 65, 1981: 348–358.

Stannard K, Spalton D.J.: Sarcoidosis with Infiltration of the External Ocular Muscles, Br J Ophtalmol, 69, 1985: 562–566.

Szedélyová, L., Gašparová, D., Kuřátko, J.: Očné zmeny pri sarkoidóze. Čs Oftal, 35, 1979: 12–15.

Šach, J.: Histopatologie. In Kuchynka, P. a spol.: Oční lékařství, (1. vyd.) Grada, Praha, 2008, s. 61–97.

Uher, M.: Sarkoidóza očnice s benigním průběhem. Čs oftal.19, 1963: 333–337.

Wong, E.K., Husain, A., Sayer, J.A.: Sar - coidosis Presenting with Hypercalcemia Following Withdrawal of Long-term Immunosuppression in Renal Transplantation. Oxf Med Case Reports, 5, 2014: 86–88. subpopulation. A higher number of epitheloid cells appears, as well as increased production of lymphokines, the CD4/CD8 ratio increases (12), previously indicated as the immunoregulation index. The increase of this ratio was detected in 100% of cases in BAL in 30 patients (5). These examinations also include determination of the HLA locus, HLA-DRB1 0401 allele is considered significant (24), which is common for the black and white population. Proprionibacterium acnes was detected in granulomas of epiretinal membranes in patients with uveitis secondary to sarcoidosis. It still remains to determine the significance of this etiology in the pathogenesis of uveitis (11).CONCLUSION Ocular sarcoidosis may incorporate any part of the eye and its auxiliary organs. The most common manifestation is uve