Journal français d'ophtalmologie
-
Multicenter Study
[Ocular and neuro-ophthalmic manifestations of sarcoidosis: retrospective study of 30 cases].
The purpose of this study was to describe the diagnostic strategy and therapeutic approach when sarcoidosis of the visual pathways is suspected, by way of a descriptive study of sarcoidosis patients in the ophthalmology services in Tours, Rennes and Angers. ⋯ Positive diagnosis of sarcoidosis requires a careful history and clinical examination, ancillary testing, and collaboration among several medical specialties. Normal angiotensin-converting enzyme levels do not rule out the diagnosis, since in our series, they were normal in almost half the cases. The tests with highest sensitivity included: a negative tuberculin skin test (100%), an elevated CD4/CD8 ratio in the BALF (100%), radiographic evidence of sarcoidosis on chest CT (79%) and brain MRI (80%). Other factors contributing to the diagnosis were: female gender (83%), age over 40 (67%), arthralgia (41%), asthenia (50%), vitritis (67%) and multifocal choroiditis (30%). In our study, treatment with corticosteroids resulted in significant improvement in over 80% of patients.