CLINICAL-DIAGNOSIS OF OCULAR SARCOIDOSIS

Purpose: To assess the value of raised serum angiotensin converting en zyme (ACE) levels in making a clinical diagnosis of ocular sarcoidosis in patients with intraocular inflammation, compatible with sarcoidosi s, in whom tissue biopsy is either not practical or not possible, Meth ods The ocular manifestations and clinical course of 22 patients with intraocular inflammation compatible with sarcoidosis and elevated ACE level (including 11 patients with abnormal chest radiograph) were comp ared with those of a group of 18 patients,vith intraocular inflammatio n due to biopsy-proven sarcoidosis. The mean follow-up (+/-SD) was 4.5 +/- 3.4 years in the presumed ocular sarcoidosis group and 7.8 +/- 5. 3 years in the biopsy-proven sarcoidosis group. Results: There was no difference in sex, race and age distribution between the two groups, N o statistically significant difference could be found between the ocul ar manifestations seen in each group, The most common finding was reti nal vasculitis with panuveitis, seen in 86.4% of the presumed ocular s arcoidosis group and in 83.3% of the biopsy-proven sarcoidosis group, Conclusions These results suggest that intraocular inflammation compat ible with sarcoidosis in conjunction with raised ACE levels would be a ccordant with a diagnosis of sarcoidosis in patients in whom. histolog ical diagnosis is either not practical or not possible.