PURPOSE

To identify multidimensional phenotypes of sarcoid uveitis patients.

DESIGN

Retrospective cohort.

METHODS

Consecutive patients with biopsy-proven, presumed, or probable sarcoid uveitis between December 2003 and December 2020 in Lyon were recruited. Data were collected from the clinical notes, and consisted in laboratory and imaging findings, systemic treatments and outcome. Systemic sarcoidosis was diagnosed according to the Abad's modified criteria and uveitis was classified according to the Standardization of Uveitis Nomenclature. A hierarchical cluster analysis was performed. The main outcome measure was identification of different phenotypes of sarcoid uveitis patients.

RESULTS

A total of 299 patients were included. Three clusters were identified: (1) younger non-Caucasian patients who presented acute (75.3%), anterior (55.6%) uveitis, and systemic manifestations (87.8%), requiring oral corticosteroids (75.3%) along with immunosuppressive therapy (17.2%) and who were more prone to experience complete visual recovery (84.1%); (2) middle-aged Caucasian patients who presented chronic (91.7%), panuveitis (79.5%), and isolated uveitis at diagnosis (74.8%), requiring systemic treatment with corticosteroids (74.0%) but less frequently immunosuppressive therapy (9.8%) and a worse prognosis (45.3% complete visual recovery); and (3) middle-aged Caucasian patients, without preferential chronic or acute uveitis, isolated uveitis at diagnosis (81.4%), more homogenous in terms of eye involvement repartition, requiring less corticosteroids or immunosuppressive therapy (respectively 54.1% and 13.1%) and having a prognosis close to cluster 2 patients (55.3% complete visual recovery).

CONCLUSIONS

This retrospective study suggested the existence of several phenotypes of sarcoid uveitis patients with different progressions and prognoses. Further studies are needed to determine the genetic and environmental factors that could explain these results.

中文翻译：

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使用聚类分析鉴定肉瘤葡萄膜炎患者的多维表型

目的

确定结节性葡萄膜炎患者的多维表型。

设计

回顾性队列。

方法

招募了 2003 年 12 月至 2020 年 12 月期间在里昂连续患有活检证实、推测或可能的结节性葡萄膜炎的患者。从临床记录中收集数据，包括实验室和影像学发现、全身治疗和结果。系统性结节病根据 Abad 修正标准诊断，葡萄膜炎根据葡萄膜炎命名标准化分类。进行了层次聚类分析。主要结果测量是识别结节性葡萄膜炎患者的不同表型。

结果

共纳入 299 名患者。确定了三个集群：(1) 出现急性 (75.3%)、前葡萄膜炎 (55.6%) 和全身表现 (87.8%) 的年轻非白种人患者，需要口服皮质类固醇 (75.3%) 以及免疫抑制治疗 (17.2%) ）以及更容易经历完全视力恢复的人（84.1%）；（2）中年高加索患者，诊断时出现慢性（91.7%）、全葡萄膜炎（79.5%）和孤立性葡萄膜炎（74.8%），需要皮质类固醇全身治疗（74.0%），但免疫抑制治疗频率较低（9.8%）预后更差（45.3% 完全视力恢复）；(3) 中年高加​​索患者，无慢性或急性葡萄膜炎优先，诊断时为孤立性葡萄膜炎（81.4%），眼部受累分布更均匀，

结论

这项回顾性研究表明存在几种具有不同进展和预后的结节性葡萄膜炎患者表型。需要进一步的研究来确定可以解释这些结果的遗传和环境因素。