This retrospective cross-sectional study examined systemic associations of sarcoid uveitis and association with uveitis clinical phenotype and ethnicity. Three hundred and sixty-two subjects with either definite or presumed sarcoid uveitis were identified and included in the study. Any subject with probable or possible sarcoid uveitis was excluded. Median age for presentation with uveitis was 46 years, and 226 (62.4%) were female. The most frequent presentations were granulomatous anterior uveitis in 47.8%, intermediate uveitis with snowballs in 46.4%, and multifocal choroiditis in 43.1%. The disease was bilateral in 313 (86.5%). Periphlebitis was observed in 21.0%, and solitary optic nerve or choroidal granuloma in 11.3%. Systemic manifestations of sarcoid uveitis were observed in 279 subjects (77.1%) but there was no association observed between the number of clinical signs of sarcoid uveitis and systemic manifestations. Lung parenchymal disease was diagnosed in 200 subjects (55.2%) and those patients were more likely to have a diagnosis of sarcoidosis before uveitis. Cutaneous sarcoid was diagnosed in 98 (27.1%), sarcoid arthritis in 57 (15.7%), liver involvement in 21 (5.8%), neurosarcoid in 49 (13.5%), and cardiac sarcoid in 16 subjects (4.4%). Subjects with cardiac sarcoid were less likely to have granulomatous anterior uveitis (p=.017). This study was the largest of its kind to examine patients with sarcoid uveitis and the systemic manifestations. Caucasian subjects were older at presentation (48 vs. 41 years; p=.009), had less granulomatous anterior uveitis (26.4% vs. 51.7%; p<.001), and were less likely to present with cutaneous involvement (23.1% vs. 35.4%; p=.040). Further research is required to assess whether screening for ophthalmic involvement in those with known systemic sarcoidosis would be beneficial.
Sarcoid uveitis and its systemic associations
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