Clinical aspects of posterior uveitis in ocular sarcoidosis.

Two clinical forms of the "white spot" syndrome in patients with posterior uveitis in definitive and presumable ocular sarcoidosis were analyzed. Group 1 was characterized by periphlebitis and discrete white spots around the vein of the retina, so-called "candle-wax", whereas group 2 showed yellow-orange solitary nodules located at the choroid, i.e. multifocal choroiditis. Visual acuity and the severity of clinical presentation were assessed in both groups. Visual acuity, Snellen equivalent was 0.52 +/- 0.36 in group 1 and 0.82 +/- 0.39 in group 2 with lesions at the level of choroid. One-way analysis of variance ANOVA showed a statistically significant between-group difference in visual acuity (p = 0.03). The mean severity of clinical presentation was 11.80 +/- 2.04 points in group 1 and 5.80 +/- 4.18 points in group 2. T-test for independent samples yielded a statistically significant difference between the groups (p = 0.02). A statistically significant difference in visual acuity was the result of vasculitis in the group with the "candle-wax" phenomenon, which is associated with retinal vasculitis and causes cystoid macular edema and reduction of visual acuity. Complications such as cataract, glaucoma and neovascularization, which also decrease visual acuity, were more frequent in group 1.

The efficacy of novel therapeutic modalities of isolated ocular vasculitis vs ocular vasculitis as a systemic disease.

AIM: To evaluate the efficacy of new therapeutic modalities with the observation period of three years on patients with isolated ocular vasculitis in comparison with ocular vasculitis as a systemic disease. METHODS: The effectiveness of the therapy was assessed based on the changes in visual acuity and degree of ocular inflammation (mild, medium, moderate, severe) with the following parameters: vitreous body cloudiness, blood vessels layering, macula oedema, blood vessels occlusion and new vascularisation RESULTS: New therapeutic modalities resulted in reduction in the number of patients with severe inflammation in the group of isolated ocular vasculitis from 8(13.5%) to 7(12.2%) after three years, while the number of patients with mild inflammation increased from 13(20.7%) to 18 (29.3%) in the same group (p>0.05). The number of patients with severe ocular inflammation in a group of ocular vasculitis as systemic disease increased from 3(16.2%) to 4(21.6%), because of the presence of patients with Behçet's disease. The number of patients with visual acuity less than 0.1 decreased from 11(17%) to 8(13.4%) in a group of patients with ocular vasculitis as systemic disease, which was associated with the presence of Behçet's disease too (p>0.05). CONCLUSIONS: Although the effect of new therapeutic modalities did not result in statistically significant improvement in visual acuity and reducing inflammation, systemic and intravitreal corticosteroids with steroid-sparing immunomodulatory therapy represents effective strategies in forms of isolated ocular vasculitis and ocular vasculitis as systemic disease.