[Clinical characteristics of patients with biopsy-proven sarcoid uveitis]

Objective: To investigate the clinical features of patients with biopsy-proven sarcoid uveitis. Methods: The clinical data of the patients with biopsy-proven sarcoid uveitis who consulted the Ophthalmic Clinic of Beijing Tongren Hospital from February 2012 to February 2020 was retrospectively reviewed and analyzed. All the patients underwent visual acuity test, slit lamp microscopy, indirect ophthalmoscopy, fundus fluorescein angiography (FFA), chest computed tomography (CT) and other auxiliary examinations. Results: A total of 9 patients (18 eyes) (6 females, 3 males) with biopsy-proven sarcoid uveitis were included in the study, with a mean age of (52.6±9.0) years. Based on the modified Scadding classification, there were 2 and 7 cases of Stage Ⅰ and Ⅱ sarcoidosis, respectively. The ocular symptoms were the initial presenting complaints in 6 patients, who had a time from onset to diagnosis of 9.0 (2.6, 20.3) months. Three patients had a history of sarcoidosis. Fever was reported in 2 patients, fatigue in 3 patients, body weight loss in 3 patients, respiratory problems in 5 patients, with bilateral ocular involvement in all the patients. Among the 18 eyes, panuveitis occurred in 10 eyes, posterior uveitis in 4 eyes, anterior uveitis in 4 eyes, mutton fat keratic precipitates (KP) in 10 eyes, granular KP or no obvious KP in 8 eyes, posterior synechia of the iris in 9 eyes, cataract in 8 eyes, inflammatory vitreous opacity in 8 eyes, macular edema in 7 eyes, epiretinal membrane in 6 eyes, retinal vasculitis in 2 eyes, glaucoma in 2 eyes, and optic disc granuloma in 2 eye. Among the 13 eyes whose peripheral ocular fundus was visible, multiple chorioretinal peripheral lesions were found in 5 eyes. Conclusions: Chest CT should be performed in the uveitis patients with older age, female gender, bilateral ocular involvement, the symptom of fever, body weight loss and respiratory problems in time to exclude the sarcoid uveitis. Sarcoid uveitis may presents with granular KP or no obvious KP, and the posterior segment of the eye ball was the most commonly involved area.

目的： 探讨经组织病理学检查确诊的结节病葡萄膜炎的临床特征。 方法： 回顾性分析2012年2月至2020年2月于北京同仁医院眼科就诊并经组织病理学检查确诊的结节病葡萄膜炎患者的临床资料。辅助检查包括视力、裂隙灯显微镜及间接检眼镜、荧光素眼底血管造影（FFA）、胸部CT等。 结果： 共纳入9例（18眼）经组织病理学检查诊断为结节病葡萄膜炎患者，其中男3例，女6例，年龄（52.6±9.0）岁。结节病临床分期：Ⅱ期7例，Ⅰ期2例。6例患者因眼部症状就诊，从发病到确诊为结节病葡萄膜炎时间为9.0（2.6，20.3）个月。3例既往有结节病病史。2例有发热，3例有乏力，3例有体重减轻，5例有呼吸系统症状。均为双眼发病。其中，全葡萄膜炎10眼，后葡萄膜炎4眼，前葡萄膜炎4眼。羊脂状角膜后沉着物（KP）10眼，颗粒状或无明显KP 8眼。虹膜后粘连9眼，白内障8眼，玻璃体炎性混浊8眼，黄斑水肿7眼，黄斑前膜6眼，视网膜血管炎2眼，青光眼2眼、视盘肉芽肿2眼。可查到周边眼底的13眼中，5眼可见周边多发脉络膜视网膜炎性病灶。 结论： 老年、女性、双眼发病及伴有发热、体重减轻和呼吸系统症状的葡萄膜炎患者应及时检查胸部CT，以排除结节病葡萄膜炎。结节病葡萄膜炎可表现为颗粒状KP或无明显KP，眼后节是其主要受累部位。.

Keywords: Disease attributes; Sarcoidosis; Uveitis.