Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 1-2, Pages: 13-16
https://doi.org/10.2298/SARH1302013J
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Clinical profile of presumed and definitive ocular sarcoidosis
Jovanović Svetlana (Klinički centar Kragujevac, Klinika za očne bolesti, Kragujevac + Medicinski fakultet, Kragujevac)
Zlatanović Gordana (Klinički centar, Klinika za očne bolesti, Niš + Medicinski fakultet, Niš)
Jovanović Zorica (Medicinski fakultet, Odeljenje za patofiziologiju, Kragujevac)
Radotić Filip (Medicinski fakultet, Kragujevac)
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.
Keywords: sarcoidosis, vasculitis, candle-wax, white dot