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Ethnicity and association with ocular, systemic manifestations and prognosis in 194 patients with sarcoid uveitis

  • Charlotte Coulon
  • Laurent Kodjikian
  • Cédric Rochepeau
  • Laurent Perard
  • Sabine Jardel
  • Carole Burillon
  • Christiane Broussolle
  • Yvan Jamilloux
  • Pascal SeveEmail author
Inflammatory Disorders

Abstract

Objective

To determine the ophthalmological and extra-ophthalmological clinical characteristics and visual prognosis of patients with sarcoid uveitis in different ethnic groups.

Methods

We retrospectively analysed the data from patients with sarcoid uveitis seen at two departments of Ophthalmology between December 2003 and December 2017. Patients presented biopsy-proven sarcoidosis and/or presumed sarcoid uveitis based on the following criteria: compatible thoracic imaging, associated with elevated angiotensin-conversion enzyme (ACE) and/or lymphocytic alveolitis on bronchoalveolar lavage fluid analysis (> 15% lymphocytes and CD4/CD8 > 3.5). Ophthalmological and general characteristics, as well as visual and global prognoses, were compared in three pre-defined ethnic groups: White Europeans, North Africans and Afro-Caribbeans.

Results

A total of 194 patients were included: 145 with biopsy-proven and 49 with presumed sarcoid uveitis. Overall, 68% were White Europeans while 20.6% were North Africans and 11.3% were Afro-Caribbeans. Sixty-nine per cent were women and the median age at presentation was 52.1 years. Median ages at first ocular manifestation of the disease in Afro-Caribbeans and North Africans were respectively 34.3 and 43.1 years, while it was 57.8 years in White Europeans (p < 0.001). Ocular involvement was bilateral in 77.8% (n = 151) of the cases and nearly half of the patients had panuveitis (48.5%). Anterior uveitis was more frequent in Afro-Caribbeans (59.1%; p < 0.0001), while White Europeans presented more frequently with intermediate uveitis. There was a significantly higher frequency of systemic involvement of sarcoidosis in North Africans while White Europeans showed a higher frequency of isolated ocular involvement at onset and during follow-up. Afro-Caribbeans, who had a complete visual recovery in 72.7% of the cases, had a better visual prognosis than other ethnic groups (p = 0.025).

Conclusion

In this large European series of sarcoid uveitis, we observed ethnicity-related differences regarding uveitis clinical presentation and visual outcome. Although good overall, the visual prognosis seems to be better in Afro-Caribbeans than in other ethnic groups.

Keywords

Uveitis Sarcoidosis Inflammation Ethnicity Prognosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the French Ophthalmology Society and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Charlotte Coulon
    • 1
    • 2
  • Laurent Kodjikian
    • 1
    • 2
  • Cédric Rochepeau
    • 3
    • 2
  • Laurent Perard
    • 4
  • Sabine Jardel
    • 2
    • 5
  • Carole Burillon
    • 3
    • 2
  • Christiane Broussolle
    • 2
    • 5
  • Yvan Jamilloux
    • 2
    • 5
  • Pascal Seve
    • 2
    • 5
    • 6
    Email author
  1. 1.Department of Ophthalmology, Croix-Rousse University HospitalHospices Civils de LyonLyonFrance
  2. 2.University Claude Bernard Lyon 1VilleurbanneFrance
  3. 3.Department of Ophthalmology, Edouard Herriot University HospitalHospices Civils de LyonLyonFrance
  4. 4.Department of Internal MedicineSaint Joseph Saint Luc HospitalLyonFrance
  5. 5.Department of Internal Medicine, Croix-Rousse University HospitalHospices Civils de LyonLyonFrance
  6. 6.Service de Médecine InterneHôpital de la Croix-Rousse, France; Univ. Lyon, University Claude Bernard Lyon 1F-69008 LyonFrance

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