Ocular sarcoidosis: clinical experience and recent pathogenetic and therapeutic advancements.
Angiotensin-converting enzyme
Bronchoalveolar lavage
Ocular sarcoidosis
T-lymphocyte
Uveitis
Journal
International ophthalmology
ISSN: 1573-2630
Titre abrégé: Int Ophthalmol
Pays: Netherlands
ID NLM: 7904294
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
29
01
2020
accepted:
21
07
2020
pubmed:
3
8
2020
medline:
22
6
2021
entrez:
3
8
2020
Statut:
ppublish
Résumé
To describe the ocular manifestations in a cohort of patients with systemic sarcoidosis (SS). Recent advances in the pathophysiology, diagnosis, and therapy of SS are also discussed. Data from 115 Italian patients diagnosed between 2005 and 2016 were retrospectively reviewed. All but the first 17 patients underwent a comprehensive ophthalmologic examination. The diagnosis was based on clinical features, the demonstration of non-caseating granulomas in biopsies from involved organs, and multiple imaging techniques. Data on broncho-alveolar lavage fluid analysis, calcemia, calciuria, serum angiotensin-converting enzyme levels and soluble interleukin-2 receptor levels were retrieved when available. Ocular involvement, detected in 33 patients (28.7%), was bilateral in 29 (87.9%) and the presenting feature in 13 (39.4%). Anterior uveitis was diagnosed in 12 patients (36.4%), Löfgren syndrome and uveoparotid fever in one patient each (3%), intermediate uveitis in 3 patients (9.1%), posterior uveitis in 7 (21.2%), and panuveitis in 9 (27.3%). First-line therapy consisted of corticosteroids, administered as eyedrops (10 patients), sub-Tenon's injections (1 patient), intravitreal implants (9 patients), or systemically (23 patients). Second-line therapy consisted of steroid-sparing immunosuppressants, including methotrexate (10 patients) and azathioprine (10 patients). Based on pathogenetic indications that tumor necrosis factor (TNF)-α is a central mediator of granuloma formation, adalimumab, targeting TNF-α, was employed in 6 patients as a third-line agent for severe/refractory chronic sarcoidosis. Uveitis of protean type, onset, duration, and course remains the most frequent ocular manifestation of SS. Diagnostic and therapeutic advancements have remarkably improved the overall visual prognosis. An ophthalmologist should be a constant component in the multidisciplinary approach to the treatment of this often challenging but intriguing disease.
Identifiants
pubmed: 32740881
doi: 10.1007/s10792-020-01531-0
pii: 10.1007/s10792-020-01531-0
pmc: PMC7669777
doi:
Substances chimiques
Adalimumab
FYS6T7F842
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3453-3467Références
Evans M, Sharma O, LaBree L, Smith RE, Rao NA (2007) Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 114(2):325–333
pubmed: 17123620
Coulon C, Kodjikian L, Rochepeau C, Perard L, Jardel S, Burillon C et al (2019) Ethnicity and association with ocular, systemic manifestations and prognosis in 194 patients with sarcoid uveitis. Graefes Arch Clin Exp Ophthalmol 257(11):2495–2503
pubmed: 31302765
Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J (2014) Sarcoidosis. Lancet 383(9923):1155–1167
pubmed: 24090799
Mañá J, Rubio-Rivas M, Villalba N, Marcoval J, Iriarte A, Molina-Molina M et al (2017) Multidisciplinary approach and long-term follow-up in a series of 640 consecutive patients with sarcoidosis: cohort study of a 40-year clinical experience at a tertiary referral center in Barcelona, Spain. Medicine (Baltimore) 96(29):e7595
Chen ES, Moller DR (2011) Sarcoidosis—scientific progress and clinical challenges. Nat Rev Rheumatol 7(8):457–467
pubmed: 21750528
Atmaca LS, Atmaca-Sönmez P, Idil A, Kumbasar OO, Celik G (2009) Ocular involvement in sarcoidosis. Ocul Immunol Inflamm 17(2):91–94
pubmed: 19412869
Judson MA, Boan AD, Lackland DT (2012) The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis Vasc Diffuse Lung Dis 29(2):119–127
pubmed: 23461074
Jabs DA, Johns CJ (1986) Ocular involvement in chronic sarcoidosis. Am J Ophthalmol 102(3):297–301
pubmed: 3752193
Ohara K, Okubo A, Sasaki H, Kamata K (1992) Intraocular manifestations of systemic sarcoidosis. Jpn J Ophthalmol 36(4):452–457
pubmed: 1289622
Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H Jr, Bresnitz EA et al (2001) Case control etiologic study of sarcoidosis (ACCESS) research group. clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 164:1885–1889
pubmed: 11734441
Ma SP, Rogers SL, Hall AJ, Hodgson L, Brennan J, Stawell RJ, Lim LL (2019) Sarcoidosis-related uveitis: clinical presentation, disease course, and rates of systemic disease progression after uveitis diagnosis. Am J Ophthalmol 198:30–36
pubmed: 30243930
Rothova A (2000) Ocular involvement in sarcoidosis. Br J Ophthalmol 84(1):110–116
pubmed: 10611110
pmcid: 1723211
Jamilloux Y, Kodjikian L, Broussolle C, Sève P (2014) Sarcoidosis and uveitis. Autoimmun Rev 13(8):840–849
pubmed: 24704868
Pasadhika S, Rosenbaum JT (2015) Ocular sarcoidosis. Clin Chest Med 36(4):669–683
pubmed: 26593141
pmcid: 4662043
Yang SJ, Salek S, Rosenbaum JT (2017) Ocular sarcoidosis: new diagnostic modalities and treatment. Curr Opin Pulm Med 23(5):458–467
pubmed: 28622198
pmcid: 5642043
Matsou A, Tsaousis KT (2018) Management of chronic ocular sarcoidosis: challenges and solutions. Clin Ophthalmol 12:519–532
pubmed: 29593377
pmcid: 5863717
Barisani-Asenbauer T, Maca SM, Mejdoubi L, Emminger W, Machold K, Auer H (2012) Uveitis—a rare disease often associated with systemic diseases and infections—a systematic review of 2619 patients. Orphanet J Rare Dis 7:57
pubmed: 22932001
pmcid: 3503654
Llorenç V, Mesquida M, Sainz de la Maza M, Keller J, Molins B, Espinosa G et al (2015) Epidemiology of uveitis in a Western urban multiethnic population. the challenge of globalization. Acta Ophthalmol 93(6):561–567
pubmed: 25683136
Bodaghi B, Cassoux N, Wechsler B, Hannouche D, Fardeau C, Papo T et al (2001) Chronic severe uveitis: etiology and visual outcome in 927 patients from a single center. Medicine (Baltimore) 80(4):263–270
Kitamei H, Kitaichi N, Namba K, Kotake S, Goda C, Kitamura M et al (2009) Clinical features of intraocular inflammation in Hokkaido. Japan Acta Ophthalmol 87(4):424–428
pubmed: 18652578
Costabel U, Bonella F, Ohshimo S, Guzman J (2010) Diagnostic modalities in sarcoidosis: BAL, EBUS, and PET. Semin Respir Crit Care Med 31(4):404–408
pubmed: 20665390
Sobic-Saranovic D, Grozdic I, Videnovic-Ivanov J, Vucinic-Mihailovic V, Artiko V, Saranovic D et al (2012) The utility of 18F-FDG PET/CT for diagnosis and adjustment of therapy in patients with active chronic sarcoidosis. J Nucl Med 53(10):1543–1549
pubmed: 22879080
Rubini G, Cappabianca S, Altini C, Notaristefano A, Fanelli M, Stabile Ianora AA et al (2014) Current clinical use of 18FDG-PET/CT in patients with thoracic and systemic sarcoidosis. Radiol Med 119(1):64–74
pubmed: 24234183
Gundlach E, Hoffmann MM, Prasse A, Heinzelmann S, Ness T (2016) Interleukin-2 receptor and angiotensin-converting enzyme as markers for ocular sarcoidosis. PLoS ONE 11(1):e0147258
pubmed: 26799486
pmcid: 4723126
Pascual RS, Gee JB, Finch SC (1973) Usefulness of serum lysozyme measurement in diagnosis and evaluation of sarcoidosis. N Engl J Med 289(20):1074–1076
pubmed: 4742223
Thi Hong Nguyen C, Kambe N, Kishimoto I, Ueda-Hayakawa I, Okamoto H (2017) Serum soluble interleukin-2 receptor level is more sensitive than angiotensin-converting enzyme or lysozyme for diagnosis of sarcoidosis and may be a marker of multiple organ involvement. J Dermatol 44(7):789–797
pubmed: 28295528
Ungprasert P, Carmona EM, Crowson CS, Matteson EL (2016) Diagnostic utility of angiotensin-converting enzyme in sarcoidosis: a population-based study. Lung 194(1):91–95
pubmed: 26563332
Herbort CP, Rao NA, Mochizuki M (2009) Members of Scientific Committee of First International Workshop on Ocular Sarcoidosis. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm 17(3):160–169
Mochizuki M, Smith JR, Takase H, Kaburaki T, Acharya NR, Rao NA (2019) Feb 23 International Workshop on Ocular Sarcoidosis Study Group. Revised criteria of International Workshop on Ocular Sarcoidosis (IWOS) for the diagnosis of ocular sarcoidosis. Br J Ophthalmol pii: bjophthalmol-2018-313356
Brown F, Tanner LS. Lofgren Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2019 Jan https://www.ncbinlm.nih.gov/books/NBK482315
Dua A, Manadan A (2013) Images in clinical medicine. Heerfordt's syndrome, or uveoparotid fever. N Engl J Med 369(5):458
pubmed: 23902485
Judson MA, Baughman RP, Teirstein AS, Terrin ML, Yeager H Jr (1999) Defining organ involvement in sarcoidosis: the ACCESS proposed instrument. ACCESS research group. a case control etiologic study of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 16(1):75–86
pubmed: 10207945
James WE, Baughman R (2018) Treatment of sarcoidosis: grading the evidence. Expert Rev Clin Pharmacol 11(7):677–687
pubmed: 29883224
Müller-Quernheim J, Kienast K, Held M, Pfeifer S, Costabel U (1999) Treatment of chronic sarcoidosis with an azathioprine/prednisolone regimen. Eur Respir J 14(5):1117–1122
pubmed: 10596700
Baughman RP, Winget DB, Lower EE (2000) Methotrexate is steroid sparing in acute sarcoidosis: results of a double blind, randomized trial. Sarcoidosis Vasc Diffuse Lung Dis 17(1):60–66
pubmed: 10746262
Rathinam SR, Babu M, Thundikandy R, Kanakath A, Nardone N, Esterberg E et al (2014) A randomized clinical trial comparing methotrexate and mycophenolate mofetil for noninfectious uveitis. Ophthalmology 121(10):1863–1870
pubmed: 24917273
pmcid: 4177935
Baughman RP, Shipley R, Desai S, Drent M, Judson MA, Costabel U et al (2009) Sarcoidosis investigators. changes in chest roentgenogram of sarcoidosis patients during a clinical trial of infliximab therapy: comparison of different methods of evaluation. Chest 136(2):526–535
pubmed: 19395578
Baughman RP, Lower EE, du Bois RM (2003) Sarcoidosis. Lancet 361(9363):1111–1118
pubmed: 12672326
Ungprasert P, Tooley AA, Crowson CS, Matteson EL, Smith WM (2019) Clinical characteristics of ocular sarcoidosis: a population-based study 1976–2013. Ocul Immunol Inflamm 27(3):389–395
pubmed: 29023165
Abad S, Meyssonier V, Allali J, Gouya H, Giraudet AL, Monnet D et al (2004) Association of peripheral multifocal choroiditis with sarcoidosis: a study of thirty-seven patients. Arthritis Rheum 51(6):974–982
pubmed: 15593175
Prasse A (2016) The diagnosis, differential diagnosis, and treatment of sarcoidosis. Dtsch Arztebl Int 113(33–34):565–574
pubmed: 27598883
pmcid: 5015588
Schupp JC, Freitag-Wolf S, Bargagli E, Mihailović-Vučinić V, Rottoli P, Grubanovic A et al (2018) Phenotypes of organ involvement in sarcoidosis. Eur Respir J 51(1):1700991
pubmed: 29371378
Angi MR, Forattini F, Chilosi M, Cipriani A, De Caro G, Semenzato G (1990) Immunopathology of ocular sarcoidosis. Int Ophthalmol 14(1):1–11
pubmed: 2182560
Ziegenhagen MW, Rothe ME, Zissel G, Müller-Quernheim J (2002) Exaggerated TNFalpha release of alveolar macrophages in corticosteroid resistant sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 19(3):185–190
pubmed: 12405487
Zissel G, Prasse A, Müller-Quernheim J (2010) Immunologic response of sarcoidosis. Semin Respir Crit Care Med 31(4):390–403
pubmed: 20665389
Zissel G, Prasse A, Müller-Quernheim J (2007) Sarcoidosis–immunopathogenetic concepts. Semin Respir Crit Care Med 28(1):3–14
pubmed: 17330188
Erckens RJ, Mostard RL, Wijnen PA, Schouten JS, Drent M (2012) Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis. Graefes Arch Clin Exp Ophthalmol 250(5):713–720
pubmed: 22119879
Saketkoo LA, Baughman RP (2016) Biologic therapies in the treatment of sarcoidosis. Expert Rev Clin Immunol 12(8):817–825
pubmed: 27117719
Adler BL, Wang CJ, Bui TL, Schilperoort HM, Armstrong AW (2019) Anti-tumor necrosis factor agents in sarcoidosis: a systematic review of efficacy and safety. Semin Arthritis Rheum 48(6):1093–1104
pubmed: 30446173
Hassan M, Karkhur S, Bae JH, Halim MS, Ormaechea MS, Onghanseng N et al (2019) New therapies in development for the management of non-infectious uveitis: a review. Clin Exp Ophthalmol 47(3):396–417
pubmed: 30938012
Perez-Alvarez R, Pérez-de-Lis M, Ramos-Casals M (2013) Biologics-induced autoimmune diseases. Curr Opin Rheumatol 25(1):56–64
pubmed: 23114587
Ramos-Casals M, Perez-Alvarez R, Diaz-Lagares C, Cuadrado M-J, Khamashta MA (2010) Autoimmune diseases induced by biological agents: a double-edged sword? Autoimmun Rev 9(3):188–193
pubmed: 19854301
Heiligenhaus A, Wefelmeyer D, Wefelmeyer E, Rösel M, Schrenk M (2011) The eye as a common site for the early clinical manifestation of sarcoidosis. Ophthalmic Res 46(1):9–12
pubmed: 21099232
Birnbaum AD, French DD, Mirsaeidi M, Wehrli S (2015) Sarcoidosis in the national veteran population: association of ocular inflammation and mortality. Ophthalmology 122(5):934–938
pubmed: 25687027
pmcid: 4414801
Acharya NR, Browne EN, Rao N, Mochizuki M (2018) Distinguishing features of ocular sarcoidosis in an international cohort of uveitis patients. Ophthalmology 125(1):119–126
pubmed: 28823384