May 31, 2019 Conference


Sarcoid Uveitis

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Dr. Nicholas Butler, VA Boston Healthcare System (Presenter)

Sarcoidosis, a multisystem inflammatory disorder of unknown etiology, may present with ocular involvement in a significant proportion of patients. Numerous exam findings increase the suspicion for sarcoid uveitis-- mutton-fat keratic precipitates, iris nodules, vitreous snowballs, retinal periphlebitis, peripheral chorioretinal white spots, and choroidal granulomas-- but none is pathognomonic. Definitive diagnosis may be elusive and requires histologic examination of involved tissue, demonstrating non-caseating granulomas. In the absence of available tissue, various serum and ocular fluid profiles can provide additional support for the diagnosis. Numerous treatment strategies have demonstrated efficacy in sarcoidosis-associated uveitis, from local steroid therapy to systemic biologics. Therapeutic decisions are informed by the disease severity, in the eyes as well as other end-organ systems, and often require multidisciplinary collaboration.