Ocular Sarcoidosis. Update on your diagnosis and treatment.
Keywords:
Palabras clave: sarcoidosis, uveítis, corticoides.Abstract
Abstract
Introduction: Sarcoidosis is a chronic multisystem inflammatory disease of unknown etiology, characterized by the presence of non-caseating granulomas in various organs such as the lung, skin, lymph nodes, heart, liver and eyes. Objective: To update knowledge on the diagnosis and treatment of ocular sarcoidosis. Method: A bibliographic search was conducted that included 42 articles related to ocular manifestations, diagnosis and treatment of ocular sarcoidosis. Development: Ocular sarcoidosis can affect any structure of the eye. Bilateral granulomatous anterior uveitis is usually one of the most frequent alterations. Studies are performed to determine the CD4+/CD8+ ratios in the aqueous humor and vitreous, compared with serum levels. Conclusions: Ocular manifestations of sarcoidosis may be the presentation of the systemic disease.
Downloads
References
Referencias Bibliográficas
Ungprasert P, Tooley AA, Crowson CS, Matteson EL, Smith WM. Clinical Characteristics of Ocular Sarcoidosis: A Population-Based Study 1976-2013. Ocul Immunol Inflamm. 2019;27(3):389-395. doi: 10.1080/09273948.2017.1386791. Epub 2017 Oct 12. PMID: 29023165; PMCID: PMC5897175. [Internet]. 2019 [cited 2024 Oct 9];27(3). Available from: https://pubmed.ncbi.nlm.nih.gov/29023165/
Takase H. Characteristics and management of ocular sarcoidosis. Immunol Med. 2022 Mar;45(1):12-21. doi: 10.1080/25785826.2021.1940740. Epub 2021 Jul 2. PMID: 34214013.
Wolfensberger TJ, Herbort CP. Indocyanine green angiographic features in ocular sarcoidosis. Ophthalmology. 1999 Feb;106(2):285-9. doi: 10.1016/S0161-6420(99)90067-2. PMID: 9951478.
Sonoda KH, Hasegawa E, Namba K, Okada AA, Ohguro N, Goto H; JOIS (Japanese Ocular Inflammation Society) Uveitis Survey Working Group. Epidemiology of uveitis in Japan: a 2016 retrospective nationwide survey. Jpn J Ophthalmol. 2021 Mar;65(2):184-190. doi: 10.1007/s10384-020-00809-1. Epub 2021 Mar 11. PMID: 33694024.
Bajwa A, Osmanzada D, Osmanzada S, Khan I, Patrie J, Xin W, Reddy AK. Epidemiology of uveitis in the mid-Atlantic United States. Clin Ophthalmol. 2015 May 20;9:889-901. doi: 10.2147/OPTH.S80972. PMID: 26056428; PMCID: PMC4445955.
Meguro A, Ishihara M, Petrek M, Yamamoto K, Takeuchi M, Mrazek F, et al. Genetic control of CCL24, POR, and IL23R contributes to the pathogenesis of sarcoidosis. Commun Biol. 2020 Aug 21;3(1):465. doi: 10.1038/s42003-020-01185-9. PMID: 32826979; PMCID: PMC7442816.
Lee H, Eom M, Kim SH, Wang HY, Lee H, Choi EH. Identification of Mycobacterium tuberculosis and non-tuberculous mycobacteria from cutaneous sarcoidosis lesions by reverse blot hybridization assay. J Dermatol. 2019 Oct;46(10):917-921. doi: 10.1111/1346-8138.15042. Epub 2019 Aug 7. PMID: 31392741.
Gandhi S, Paranjpe R, Radhakrishnan O, Goyal K, Goli KB. A Case of Ocular Sarcoidosis Post-COVID-19 Vaccination. Cureus. 2023 Nov 23;15(11):e49303. doi: 10.7759/cureus.49303. PMID: 38903489; PMCID: PMC11187454.
O'Keefe GAD, Rao NA. Progress in the diagnosis of ocular sarcoidosis. Indian J Ophthalmol. 2022 Apr;70(4):1121-1129. doi: 10.4103/ijo.IJO_2830_21. PMID: 35325997; PMCID: PMC9240545.
Takase H, Acharya NR, Babu K, Bodaghi B, Khairallah M, McCluskey PJ, et al. Recommendations for the management of ocular sarcoidosis from the International Workshop on Ocular Sarcoidosis. Br J Ophthalmol. 2021 Nov;105(11):1515-1519. doi: 10.1136/bjophthalmol-2020-317354. Epub 2020 Sep 15. PMID: 32933934.
Hwang DK, Sheu SJ. An update on the diagnosis and management of ocular sarcoidosis. Curr Opin Ophthalmol. 2020 Nov;31(6):521-531. doi: 10.1097/ICU.0000000000000704. PMID: 33009085.
Shin D, Kim S, Kong M, Kim BH, Song SJ. Prevalence and Incidence of Uveitis in Korean Patients with Sarcoidosis: A Population-Based Study. Ocul Immunol Inflamm. 2024 Nov 25:1-6. doi: 10.1080/09273948.2024.2430708. Epub ahead of print. PMID: 39586060.
Babu K, Kini R, Mehta R. Scleral nodule and bilateral disc edema as a presenting manifestation of systemic sarcoidosis. Ocul Immunol Inflamm. 2010 Jun;18(3):158-61. doi: 10.3109/09273941003753416. PMID: 20482388.
Starshinova A, Berg E, Rubinstein A, Kulpina A, Kudryavtsev I, Kudlay D. Chronic Sarcoidosis: Diagnostic Difficulties and Search for New Criteria of Inflammatory Activity (A Case Report and Literature Review). J Clin Med. 2024 Nov 19;13(22):6974. doi: 10.3390/jcm13226974. PMID: 39598118; PMCID: PMC11594891.
Ranjan R, Rai S, Kumar Srivastava A. "Master Of Disguises: Neurosarcoidosis Presenting As Multiple Discrete Dural Based Masses". World Neurosurg. 2025 Feb 3:123748. doi: 10.1016/j.wneu.2025.123748. Epub ahead of print. PMID: 39909108.
Han, YE, Jo, J., Kim, HC et al. Manifestaciones coroideas de la sarcoidosis no ocular: un estudio de OCT con imágenes de profundidad mejorada. BMC Ophthalmol 24, 199 (2024). https://doi.org/10.1186/s12886-024-03463-0
Mehta H, Sim DA, Keane PA, Zarranz-Ventura J, Gallagher K, Egan CA, et al. Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis. Eye (Lond). 2015 Aug;29(8):1060-8. doi: 10.1038/eye.2015.65. Epub 2015 May 29. PMID: 26021867; PMCID: PMC4541349.
Agarwal A, Aggarwal K, Pichi F, Meng T, Munk MR, Bazgain K, Bansal R, Agrawal R, Gupta V. Clinical and Multimodal Imaging Clues in Differentiating Between Tuberculomas and Sarcoid Choroidal Granulomas. Am J Ophthalmol. 2021 Jun;226:42-55. doi: 10.1016/j.ajo.2021.01.025. Epub 2021 Jan 30. PMID: 33529591.
Mahendradas P, Maruyama K, Mizuuchi K, Kawali A, Kitaichi N. Multimodal Imaging in Ocular Sarcoidosis. Ocul Immunol Inflamm. 2020 Nov 16;28(8):1205-1211. doi: 10.1080/09273948.2020.1751210. Epub 2020 May 12. PMID: 32396030.
Yang SJ, Salek S, Rosenbaum JT. Ocular sarcoidosis: new diagnostic modalities and treatment. Curr Opin Pulm Med. 2017 Sep;23(5):458-467. doi: 10.1097/MCP.0000000000000409. PMID: 28622198; PMCID: PMC5642043.
Reznicek L, Seidensticker F, Stumpf C, Kampik A, Thurau S, Kernt M, et al. Systematic analysis of wide-field fundus autofluorescence (FAF) imaging in posterior uveitis. Curr Eye Res. 2014 Feb;39(2):164-71. doi: 10.3109/02713683.2013.834938. Epub 2013 Oct 21. PMID: 24144279.
Groen-Hakan F, Eurelings L, Rothova A, van Laar J. Lymphopaenia as a predictor of sarcoidosis in patients with a first episode of uveitis. Br J Ophthalmol. 2019 Sep;103(9):1296-1300. doi: 10.1136/bjophthalmol-2018-313212. Epub 2018 Nov 15. PMID: 30442816.
Rao A, Hwang J, Wen J, Edminster S, Sibug-Saber M, Rao N, Toy BC. Clinico-pathologic correlation in ocular sarcoidosis. Am J Ophthalmol Case Rep. 2024 Nov 5;36:102220. doi: 10.1016/j.ajoc.2024.102220. PMID: 39583292; PMCID: PMC11584688.
Takase H. Characteristics and management of ocular sarcoidosis. Immunol Med. 2022 Mar;45(1):12-21. doi: 10.1080/25785826.2021.1940740. Epub 2021 Jul 2. PMID: 34214013.
Mochizuki M, Smith JR, Takase H, Kaburaki T, Acharya NR, Rao NA; International Workshop on Ocular Sarcoidosis Study Group. Revised criteria of International Workshop on Ocular Sarcoidosis (IWOS) for the diagnosis of ocular sarcoidosis. Br J Ophthalmol. 2019 Oct;103(10):1418-1422. doi: 10.1136/bjophthalmol-2018-313356. Epub 2019 Feb 23. PMID: 30798264.
Salazar JA, Sarmiento D, Hubbe C, Concha del Rio LE. Sarcoidosis: experience in a Mexican ophthalmological clinic. BMC Ophthalmol. 2023 Jul 20;23(1):330. doi: 10.1186/s12886-023-03081-2. PMID: 37474932; PMCID: PMC10357619.
Dammacco R, Biswas J, Kivelä TT, Zito FA, Leone P, Mavilio A, et al. Ocular sarcoidosis: clinical experience and recent pathogenetic and therapeutic advancements. Int Ophthalmol. 2020 Dec;40(12):3453-3467. doi: 10.1007/s10792-020-01531-0. Epub 2020 Aug 1. PMID: 32740881; PMCID: PMC7669777.
Flores JLR, de Ceballos EPG, Hernández-Cruz B, Muñoz AHA, Machuca-Aguado J, Gallardo SR, Venegas JJP. Refractory multisystemic sarcoidosis, a diagnosis and treatment challenge: a case report. J Med Case Rep. 2023 Jun 29;17(1):303. doi: 10.1186/s13256-023-03996-w. PMID: 37386509; PMCID: PMC10311802.
Rodas JL, Peral E, Hernández B, Álvarez AH, Machuca J, Recio S, Pérez JJ. Refractory multisystemic sarcoidosis, a diagnosis and treatment challenge: a case report. J Med Case Rep. 2023 Jun 29;17(1):303. doi: 10.1186/s13256-023-03996-w. PMID: 37386509; PMCID: PMC10311802.
Han YE, Jo J, Kim HC, Lee J. Choroidal manifestations of non-ocular sarcoidosis: an enhanced depth imaging OCT study. BMC Ophthalmol. 2024 Apr 26;24(1):199. doi: 10.1186/s12886-024-03463-0. PMID: 38671442; PMCID: PMC11046746.
Zaher S, Kozyreff A, Pothen L, Yildiz H. Ocular Sarcoidosis as Initial Presentation of the Disease: Clinical Characteristics and Risk Factors Associated with Disease Recurrence. Ocul Immunol Inflamm. 2025 Feb;33(2):287-294. doi: 10.1080/09273948.2024.2404077. Epub 2024 Sep 16. PMID: 39284076.
Liu HM, Lai YJ, Chiu FY, Chan WC. Ocular Sarcoidosis Masquerading as Acute Retinal Necrosis: Two Case Reports. Retin Cases Brief Rep. 2024 Jul 19. doi: 10.1097/ICB.0000000000001639. Epub ahead of print. PMID: 39029126.
Xiong F, Acharya N, Rao N, Mochizuki M, Lietman TM, Gonzales JA. Ocular Signs and Testing Most Compatible with Sarcoidosis-Associated Uveitis: A Latent Class Analysis. Ophthalmol Sci. 2024 Mar 3;4(5):100503. doi: 10.1016/j.xops.2024.100503. PMID: 38881612; PMCID: PMC11179406.
Asakage M, Usui Y, Komatsu H, Maruyama K, Nezu N, Shimizu H, Tsubota K, Yamakawa N, Umezu T, Takanashi M, Kuroda M, Goto H. Comprehensive microRNA analyses using vitreous humor of ocular sarcoidosis. Graefes Arch Clin Exp Ophthalmol. 2024 Sep 9. doi: 10.1007/s00417-024-06619-2. Epub ahead of print. PMID: 39249513.
Ngo LC, Nahon-Estève S, Maschi C, Martel A, Lassalle S, Tieulie N, Baillif S. Clinical features, diagnosis, treatment, and course of ocular sarcoidosis with or without uveitis: A retrospective, comparative study. J Fr Ophtalmol. 2024 Mar 29;47(5):104153. doi: 10.1016/j.jfo.2024.104153. Epub ahead of print. PMID: 38696861.
Badash A, Whittington K, Ene A, Zorra I, Rubinstein I, Tsoukas M, Sweiss NJ. Pulmonary, Ocular, and Cardiac Involvement in Patients With Cutaneous Sarcoidosis of the Face and Head. J Cutan Med Surg. 2024 Nov 1:12034754241293083. doi: 10.1177/12034754241293083. Epub ahead of print. PMID: 39487588.
Obijiofor C, Sikora M, Moshiri AS, Alam M, Lo Sicco KI, Imadojemu S, Caplan AS. Clinicopathologic features, demographics, disease burden, and therapeutics in alopecic sarcoidosis: a case series and systematic review. Int J Womens Dermatol. 2024 Sep 13;10(3):e181. doi: 10.1097/JW9.0000000000000181. PMID: 39281007; PMCID: PMC11398751.
Putera I, Schrijver B, Kolijn PM, van Stigt AC, Ten Berge JCEM, IJspeert H, Nagtzaam NMA, Swagemakers SMA, van Laar JAM, Agrawal R, Rombach SM, van Hagen PM, La Distia Nora R, Dik WA. A serum B-lymphocyte activation signature is a key distinguishing feature of the immune response in sarcoidosis compared to tuberculosis. Commun Biol. 2024 Sep 10;7(1):1114. doi: 10.1038/s42003-024-06822-1. PMID: 39256610; PMCID: PMC11387424.
Asakage M, Usui Y, Komatsu H, Maruyama K, Nezu N, Shimizu H, Tsubota K, Yamakawa N, Umezu T, Takanashi M, Kuroda M, Goto H. Comprehensive microRNA analyses using vitreous humor of ocular sarcoidosis. Graefes Arch Clin Exp Ophthalmol. 2024 Sep 9. doi: 10.1007/s00417-024-06619-2. Epub ahead of print. PMID: 39249513.
Ranjan R, Rai S, Kumar Srivastava A. "Master Of Disguises: Neurosarcoidosis Presenting As Multiple Discrete Dural Based Masses". World Neurosurg. 2025 Feb 3:123748. doi: 10.1016/j.wneu.2025.123748. Epub ahead of print. PMID: 39909108.
Ferracioli-Oda E, Kawassaki AM, Arimura FE, Kairalla RA, Hirata CE, Yamamoto JH. Clinical and epidemiological profile of patients with definite ocular sarcoidosis at a Brazilian referral center. Arq Bras Oftalmol. 2022 Nov 4;85(6):644-646. doi: 10.5935/0004-2749.2022-00131. PMID: 36350928.
Obi ON, Saketkoo LA, Maier LA, Baughman RP. Developmental drugs for sarcoidosis. J Autoimmun. 2024 Dec;149:103179. doi: 10.1016/j.jaut.2024.103179. Epub 2024 Mar 28. PMID: 38548579.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Alba Rosa Govea Pacho, Rosibell Domínguez Suárez, Sully Fabiola Funez Galeas

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
