Srpski arhiv za celokupno lekarstvo · 2013
[Clinical profile of presumed and definitive ocular sarcoidosis].
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Jovanović Svetlana, Zlatanović Gordana, Jovanović Zorica, Radotić Filip
Аннотация
INTRODUCTION: Sarcoidosis is an antigen-mediated disease of unknown cause defined by granulomatous inflammation of different organs.
OBJECTIVE: The aim of this study was to analyze the clinical picture in 26 patients with a definitive and presumed ocular sarcoidosis.
METHODS: The following tests were conducted: angiotensin-converting enzyme, tuberculin skin test, liver enzymes and calcium in urine and serum. Enlarged hilar lymph glands were diagnosed using X-ray tomography or computed tomography of the mediastinum. A biopsy of lymph glands was performed either transbronchially or transmediastinally. Ophthalmic examination included biomicroscopic examination, intraocular pressure measurement, photofundus, fluorescein angiography, optical coherence tomography and computerized perimetry.
RESULTS: The average follow-up period of the disease was 6.1 years. The average age was 52.0 years. There were 62.5% female patients, with bilateral incidence of 69.2%. The clinical picture included: panuveitis (in 30.8% of patients), anterior uveitis (26.9%), posterior uveitis (26.9%), intermediate uveitis (7.7%) and vitritis in (7.7%). The following complications were observed: cataract (in 34.6% of patients), cystoid macular edema (23.1%), glaucoma (15.4%), macroaneurysms (15.4%), neovascularization (7.7%) and band keratopathy (3.8%). There was a statistically significant difference in the visual acuity (p = 0.033) and severity of clinical symptoms (p = 0.02) between the groups of patients with retinal vasculitis associated with"candle-wax" phenomenon and the group of patients with multiple chorioretinal lesions--"white dot" syndrome.
CONCLUSION: To our consideration, the differences observed between the two groups are the result of retinal vasculitis and subsequent macular edema, which is significantly more frequent in the group with"candle-wax" phenomenon.
OBJECTIVE: The aim of this study was to analyze the clinical picture in 26 patients with a definitive and presumed ocular sarcoidosis.
METHODS: The following tests were conducted: angiotensin-converting enzyme, tuberculin skin test, liver enzymes and calcium in urine and serum. Enlarged hilar lymph glands were diagnosed using X-ray tomography or computed tomography of the mediastinum. A biopsy of lymph glands was performed either transbronchially or transmediastinally. Ophthalmic examination included biomicroscopic examination, intraocular pressure measurement, photofundus, fluorescein angiography, optical coherence tomography and computerized perimetry.
RESULTS: The average follow-up period of the disease was 6.1 years. The average age was 52.0 years. There were 62.5% female patients, with bilateral incidence of 69.2%. The clinical picture included: panuveitis (in 30.8% of patients), anterior uveitis (26.9%), posterior uveitis (26.9%), intermediate uveitis (7.7%) and vitritis in (7.7%). The following complications were observed: cataract (in 34.6% of patients), cystoid macular edema (23.1%), glaucoma (15.4%), macroaneurysms (15.4%), neovascularization (7.7%) and band keratopathy (3.8%). There was a statistically significant difference in the visual acuity (p = 0.033) and severity of clinical symptoms (p = 0.02) between the groups of patients with retinal vasculitis associated with"candle-wax" phenomenon and the group of patients with multiple chorioretinal lesions--"white dot" syndrome.
CONCLUSION: To our consideration, the differences observed between the two groups are the result of retinal vasculitis and subsequent macular edema, which is significantly more frequent in the group with"candle-wax" phenomenon.