Ispitivanje učestalosti i karakteristika promena na očima kod bolesnika sa plućnom sarkoidozom
Investigation of frequency and clinical features of ocular sarcoidosis in patients with pulmonary sarcoidosis
Author
Radosavljević, Aleksandra P.
Mentor
Jakšić, VesnaCommittee members
Vučinić-Mihailović, VioletaStojković, Milenko
Jovanović, Dragana
Kovačević-Pavićević, Dragana
Metadata
Show full item recordAbstract
Uvod: Sarkoidoza je idiopatsko, multisistemsko granulomatozno inflamatorno oboljenje
nepoznate etiologije koje primarno zahvata pluća i hilarne limfne čvorove, a bilo koji organ
može biti zahvaćen uključujući oko i njegova adneksa.
Cilj: Analizirati učestalost i kliničke karakteristike sarkoidoze oka u grupi pacijenata sa
plućnom sarkoidozom.
Metode: Prospektivna studija konsekutivnih pacijenata hospitalizovanih u referentnoj
ustanovi za sarkoidozu pluća u Srbiji, u periodu od januara 2012. do decembra 2014.
godine. Dijagnoza sarkoidoze pluća je postavljena nakon patohistološke potvrde uzoraka
dobijenih bronhoskopijom. Dijagnoza sarkoidoze oka je postavljena prema kriterijumima
International Workshop on Ocular Sarcoidosis.
Rezultati: Većina pacijenata su bili starije životne dobi (prosečno 51,2 ± 11,2 godina) i
ženskog pola (76%). Prosečno trajanje sarkoidoze bilo je 5,5 ± 7,4 godina. Većina
pacijenata su imali I i II stadijum sarkoidoze pluća (65% i 31%, respektivno) i akutni
početak ...bolesti praćen hroničnim tokom (51%). Kožne promene u sklopu sarkoidoze imalo
je 25 pacijenata (28,4%), dok su periferni limfni čvorovi (5,7%), jetra (4,5%), slezina
(2,3%) i srce (4,5%) bili ređe zahvaćeni. Postojanje oftalmoloških manifestacija je utvrđeno
kod 32 pacijenta (36.4%) i uključivalo je lezije na koži kapaka (2,3%), orbitalne lezije
(2,3%), konjunktivalne lezije (7,9%), prednji uveitis (2,3%), intermedijalni uveitis (1,1%),
zadnji uveitis (15.9%), panuveitis (5,7%) i neurooftalmološke manifestacije (9,1%).
Komplikacije su činile katarakta (20,4%), glaukom (5,7%), cistoidni edem makule (3,4%),
nastanak epiretinalnih membrana (4,5%), atrofija retine (2,2%) i horoidalna
neovaskularizacija (1,1%). Binokularna slabovidost uzrokovana sarkoidozom oka utvrđena
je kod 1 pacijenta (1,1%), usled postojanja komplikacija zadnjeg uveitisa.
Zaključak: Sarkoidoza oka je bila prva po učestalosti ekstrapulmonalna manifestacija
sarkoidoze kod pacijenata u Srbiji, sa značajno češćim neurooftalmološkim promenama
nego što je to publikovano u drugim evropskim studijama.
Background: Sarcoidosis is idiopathic, multisystem granulomatous inflammatory disease
of unknown aetiology which primarily affects lungs and hilar lymph nodes, but any organ
may be involved including eye and its’ adnexa.
Aims: To analyze frequency and clinical characteristics of ocular sarcoidosis in a group of
patients with pulmonary sarcoidosis.
Methods: A prospective study of consecutive patients hospitalized between January 2012
and December 2014 at the single referral centre for sarcoidosis in Serbia. The diagnosis of
pulmonary sarcoidosis was obtained by pathohistological evaluation of tissue specimens
after bronchoscopy. Ocular sarcoidosis was diagnosed based on the international criteria of
the International Workshop on Ocular Sarcoidosis.
Results: The majority of patients were elder adults (average age of 51.2 ± 11.2 years) and
females were predominant (76%). Average duration of sarcoidosis was 5.5 ± 7.4 years. The
majority of patients had stage I and II pulmonary sarcoidosis ...(65% and 31%, respectively)
and acute onset followed by a chronic course of the disease (51%). Sarcoid skin lesions
were confirmed in 25 patients (28.4%), while peripheral lymph nodes (5.7%), liver (4.5%),
spleen (2.3%) and heart (4.5%) sarcoid lesions were less common. Ocular sarcoidosis was
present in 32 patients (36.4%) and included eyelid skin lesions (2.3%), orbital inflammation
(2.3%), conjunctival lesions (7.9%), anterior uveitis (2.3%), intermediate uveitis (1.1%),
posterior uveitis (15.9%), panuveitis (5.7%) and neuroophthalmological manifestations
(9.1%). Complications included cataract (20.4%), glaucoma (5.7%), cystoid macular edema
(3.4%), epiretinal membrane formation (4.5%), macular atrophy (2.3%) and choroidal
neovascularization (1.1%). Binocular visual impairment due to ocular sarcoidosis was
present in 1 patient (1.1%), due to complications of posterior uveitis.
Conclusion: Patients in Serbia demonstrated ocular sarcoidosis as the first most common
site of extrapulmonary sarcoid manifestations, with more often neuroophthalmological
lesions then in other European population.