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2018 ; 12
(ä): 519-532
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Management of chronic ocular sarcoidosis: challenges and solutions
#MMPMID29593377
Matsou A
; Tsaousis KT
Clin Ophthalmol
2018[]; 12
(ä): 519-532
PMID29593377
show ga
BACKGROUND: Sarcoidosis constitutes one of the leading causes of ocular
inflammation. Chronic ocular sarcoidosis can affect any segment of the eye and
its adnexa, producing a wide range of clinical manifestations and severity. If
left untreated, permanent visual impairment or even blindness may ensue.
Treatment approaches vary from topical therapy to systemic agents that induce
immunosuppression to different levels according to disease severity. OBJECTIVE:
To review the published literature on the management options for chronic ocular
sarcoidosis and provide a comprehensive list of available treatment strategies,
including the newer biologics. SUMMARY: Ocular disease remains a challenging
aspect of sarcoidosis and may even be the presenting sign of the disease. Prompt
and effective therapy may reverse visual damage and prevent permanent loss of
vision. Because of the complexity of the disease, a multidisciplinary approach is
often required, with a view to addressing both the ocular and other systemic
manifestations of sarcoidosis. Recent data suggest that achieving overall optimal
systemic control is of paramount importance in controlling eye inflammation as
well. Cytotoxic immunosuppressive agents for refractory chronic ocular disease,
as well as biologic anti-TNF? therapies, have advanced the management of chronic
disease and should be considered corticosteroid-sparing strategies before the
onset of significant steroid-induced morbidity.