[Sarcoid uveitis: Ophthalmologist's and internist's viewpoints]

Rev Med Interne. 2023 Mar;44(3):112-122. doi: 10.1016/j.revmed.2022.10.001. Epub 2023 Jan 13.
[Article in French]

Abstract

Sarcoidosis is one of the leading causes of inflammatory eye disease. All ocular structures can be affected, but uveitis is the main manifestation responsible for vision loss in ocular sarcoidosis. Typical sarcoid anterior uveitis presents with mutton-fat keratic precipitates, iris nodules, and posterior synechiae. Posterior involvement includes vitritis, vasculitis, and choroidal lesions. Cystoid macular edema is the most important and sight-threatening consequence of sarcoid uveitis. Patients with clinically isolated uveitis at diagnosis rarely develop other organ involvement. Even though, ocular sarcoidosis can have a severe impact on visual prognosis, early diagnosis and a wider range of available therapies (including intravitreal implants) have lessened the functional impact of the disease, particularly in the last decade. Corticosteroids are the cornerstone of treatment for sarcoidosis, but up to 30% of patients achieve remission with requiring high-dose systemic steroids. In these cases, the use of steroid-sparing immunosuppressive therapy (such as methotrexate) is unavoidable. Among these immunosuppressive treatments, anti TNF-α drugs have been a revolution in the management of non-infectious uveitis.

Keywords: Anti TNF-α; Sarcoidosis; Sarcoïdose; Uveitis; Uvéite.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Ophthalmologists*
  • Sarcoidosis* / complications
  • Sarcoidosis* / diagnosis
  • Tumor Necrosis Factor Inhibitors / therapeutic use
  • Uveitis* / diagnosis
  • Uveitis* / drug therapy
  • Uveitis* / etiology
  • Vision Disorders / diagnosis

Substances

  • Tumor Necrosis Factor Inhibitors
  • Immunosuppressive Agents