SAT0512 OCULAR INVOLVEMENT AND TREATMENT IN SARCOIDOSIS. STUDY OF 41 PATIENTS OF A SERIES OF 383 PATIENTS FROM A SINGLE UNIVERSITY HOSPITAL
Authors: M. Calderón-Goercke, J. J. Gaitán-Valdizán, R. Fernández-Ramón, L. Sánchez-Bilbao, R. Demetrio-Pablo, R. Blanco
Journal: Annals of the Rheumatic Diseases (2020)

Background: The eye is a common and potential severe complication of sarcoidosis. Topical and systemic corticosteroids are the first-line treatment. Conventional and biological immunosuppressants (IS) are frequently needed (1-5). Objectives: To assess the frequency, clinical and treatment of ocular involvement of sarcoidosis. Methods: Study of a large cohort (n=383) of systemic sarcoidosis from a single university hospital. All consecutive patients diagnosed with sarcoidosis from January 1,1999 to January 1,2019 according the ATS/ERS/WASOG criteria (Eur Respir J 1999;14:735–737 ) were included. Results: 41 (22 women/19 men) of 383 (10.7%) patients had ocular involvement, mean age 44.8±16 years. Uveitis (n=34; 82.9%) was the most common ocular manifestation, especially anterior uveitis (n=18; 52.9%). Ocular surface and eye orbit may also be affected (Table ). In addition to topical and systemic corticosteroids, conventional (n=23; 56.1%) and biologic (n=14; 34.1%) IS drugs were required. Adalimumab and Infliximab were the most used biologic treatments (Table). Cystoid macular edema (CME) and Retinal Vasculitis was observed in both cases in 3 (7.3%) patients, 2 of them (66.7%) required biological treatment. Papilitis appeared in 7 (17.1%) cases, biological treatment was needed in 3 (42.9%) patients. The most frequent sequels were cataract (n=9, 21.9%), intraocular hypertension (n=5; 12.2%) and pupil alterations (n=4; 9.7%). The average of the best corrected visual acuity was 0.6±0.3 at diagnosis and 0.7±0.3 after one year follow up. Conclusion: Ocular involvement of sarcoidosis is a relative frequent and potential severe complication, especially if panuveitis is presented. References: [1]Riancho-Zarrabeitia L, et al. Semin Arthritis Rheum. 2015; 45:361-8. [2]Calvo-Río V, et al. Clin Exp Rheumatol. 2014; 32:864-8. [3]Riancho-Zarrabeitia L, et al. Clin Exp Rheumatol. 2014; 32:275-84. [4]Vegas-Revenga N, et al. Am J Ophthalmol. 2019; 200:85-94. [5]Calvo-Río V, et al. Clin Exp Rheumatol. 2014;32(4 Suppl 84): S54-7. Table. Ocular manifestations of sarcoidosis and treatment with corticosteroids, conventional and biological IS. CONVENTIONAL IS BIOLOGICAL IS OCULAR INVOLVEMENT Cases TCS OCS MD of OCS IVMP CIS MTX AZA CFM MMF BT ADA IFX TCZ GLM ETN SURFACE n(%) 3(7.3) 2(66.7) 2(66.7) 2(66.7) 2(66.7) 2(66.7) 2(66.7) 1(33.3) 0(0) 2(66.7) 2(66.7) 2(66.7) 0(0) 0(0) 0(0) -CG/N, n(%) 1(33.3) 1(100) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) -PUK, n(%) 2(66.7) 1(50) 2(100) 60 2(100) 2(100) 2(100) 2(100) 1(50) 0(0) 2(100) 2(100) 2(100) 0(0) 0(0) 0(0) UVEITIS n(%) 34(82.9) 25(73.5) 28(82.3) 10(29.4) 19(55.6) 18(52.9) 7(20.6) 1(2.9) 1(2.9) 12(35.3) 11(32.3) 4(11.8) 3(8.8) 2(5.9) 1(2.9) -Anterior uveítis, n(%) 18(52.9) 11(61.1) 13(72.2) 30 1(5.5) 5(27.8) 5(27.8) 1(5.5) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) 0(0) -Posterior uveítis, n(%) 4(11.7) 2(50) 3(75) 60 1(25) 3(75) 2(50) 2(50) 0(0) 0(0) 2(50) 1(25) 0(0) 0(0) 1(25) 0(0) -Panuveítis, n(%) 12(35.3) 12(100) 12(100) 60 8(66.7) 11(91.7) 11(91.7) 4(33.3) 1(8.3) 1(8.3) 10(83.3) 10(83.3) 4(33.3) 3(25) 1(8.3) 1(8.3) EYE ORBIT n(%) 4(9.7) 2(50) 3(75) 2(50) 2(50) 2(50) 2(50) 0(0) 0(0) 2(50) 1(25) 1(25) 1(25) 0(0) 0(0) -Proptosis, n(%) 2(50) 1(50) 1(50) 30 1(50) 1(50) 1(50) 1(50) 0(0) 0(0) 1(50) 1(50) 0(0) 1(50) 0(0) 0(0) -Strabismus, n(%) 2(50) 1(50) 2(100) 60 1(50) 1(50) 1(50) 1(50) 0(0) 0(0) 1(33.3) 0(0) 1(33.3) 0(0) 0(0) 0(0) TOTAL, n(%) 41(100) 29(70.7) 33(80.5) 50±15.5 14(34.1) 23(56.1) 22(53.7) 11(26.9) 2(4.9) 1(2.4) 14(34.1) 14(34.1) 7(17.5) 3(7.3) 2(4.9) 1(2.4) TCS: topical corticosteroids; OCS: oral corticosteroids; MD: maximum dose; IVMP: intravenous methylprednisolone; CIS : conventional immunossupresors; BT: biologic therapy; CG/N: conjunctival granuloma/nodule; PUK: peripheral ulcerative keratitis Disclosure of Interests: Monica Calderón-Goercke: None declared, Jorge Javier Gaitán-Valdizán: None declared, Raúl Fernández-Ramón: None declared, Lara Sánchez-Bilbao: None declared, Rosalía Demetrio-Pablo: None declared, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD