Evaluation of characteristic ocular signs and systemic investigations in ocular sarcoidosis patients.
OBJECTIVE
To evaluate the diagnostic values of ocular signs and systemic investigations in ocular sarcoidosis, in a retrospective case-control study.


METHODS
Subjects were 67 consecutive uveitis patients with biopsy-proven sarcoidosis and 111 control patients with other clinical uveitis entities. The predictive values analyzed were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The five ocular signs for ocular sarcoidosis are (1) mutton fat keratic precipitates and iris nodules; (2) nodules at the trabecular meshwork and tent-shaped peripheral anterior synechia; (3) snowball vitreous opacities; (4) nodular periphlebitis, and (5) multiple chorioretinal lesions (active or atrophic) in the peripheral fundus. In addition, the results of the following five systemic investigations were considered: (1) negative tuberculin skin test; (2) elevated serum angiotensin-converting enzyme; (3) elevated serum lysozyme; (4) elevated serum gamma-globulin; and (5) bilateral hilar lymphadenopathy on chest X-ray.


RESULTS
The incidence of all ocular signs and positive results for the systemic investigations were significantly higher in sarcoidosis patients than in controls (P < 0.001). The presence of two or three of the five ocular signs were indicative of a positive finding in the diagnostic parameters. The presence of two positive results among the five systemic investigations showed values higher than 0.800 for all diagnostic parameters.


CONCLUSIONS
Combinations of the specified ocular signs and the results of systemic investigations can be used for the diagnosis of ocular sarcoidosis.
Kawaguchi
Tatsushi
T
Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Hanada
Atsue
A
Horie
Shintaro
S
Sugamoto
Yoshiharu
Y
Sugita
Sunao
S
Mochizuki
Manabu
M
D016022:Case-Control Studies; D015862:Choroid Diseases / Q000175:diagnosis; D005128:Eye Diseases / Q000175:diagnosis*; D005189:False Positive Reactions; D006801:Humans; D007499:Iris Diseases / Q000175:diagnosis; D010689:Phlebitis / Q000175:diagnosis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000175:diagnosis; D012169:Retinal Vein / Q000473:pathology; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014129:Trabecular Meshwork / Q000473:pathology; D014822:Vitreous Body / Q000473:pathology