Pattern of ocular sarcoidosis at a tertiary eye center in Nepal

Background: Sarcoidosis is a multisystem chronic granulomatous inflammatory disease with no proven causative agent. Very few studies have been done in Nepal regarding this disease. There is no known incidence or prevalence study done in Nepal. Also, its clinical features closely resemble tuberculosis which has high incidence and prevalence in Nepal. 1 Ocular involvement has been reported to occur in 20-50% cases of sarcoidosis. Uveitis is among the most common presentations of ocular sarcoidosis.2 In previous studies done in Nepal, sarcoidosis had been reported to be the cause of 1.6%-1.7% of total uveitis cases. 3, 4 This study has been undertaken to assess the patterns of presentation of sarcoid uveitis in a tertiary level eye hospital in Nepal. Methods: This was a retrospective observational study based on Electronic Medical Recording (EMR). 35 patients fulfilling IWOS criteria for ocular sarcoidosis were included in the study and clinical signs and symptoms were studied. Associations were sought regarding the chronicity and recurrence pattern of uveitis and demographic parameters as well as the type of uveitis at presentation, either granulomatous or non-granulomatous and the same parameters. Chi-square test was used to find the level of significance and p value of <0.05 was considered statistically significant. Results: The most common pattern of ocular sarcoidosis was bilateral (80%), anterior (91.4%) uveitis. There was no disparity regarding age, gender, caste or habitat in the occurrence of ocular sarcoidosis. Granulomatous inflammation (62.85%) was more common than non-granulomatous (31.42%) and was significantly more common in people >40 years old(p=0.036). Conclusion: Sarcoidosis should be considered in the differential diagnosis of any uveitis in our region as sarcoidosis has no known prevalence and yet has extremely variable ocular presentation.