Demographic-related variations in posterior segment ocular sarcoidosis

Objective: To compare the frequency of posterior segment involvement (PSI), the prevalence of specific posterior segment signs, and visual acuity in ocular sarcoidosis by patient race, sex, and age. Design: Retrospective, cross-sectional observational study. Participants: Seventy-six consecutive patients with biopsy-proven or presumed ocular sarcoidosis seen at the Duke University Eye Center between 1989 and 2001. Methods: Medical record review. Main Outcome Measures: Patient demographics, presence and laterality of specific posterior segment signs, and visual acuity at initial examination. Results: Of the 76 patients, 68% were black (34 female and 18 male) and 32% were white (18 female and 6 male). A total of 68 patients (89%) had PSI: black patients had 85% and white patients had 100% (P = 0.05). For patients with PSI, white females had the highest mean age at initial examination (58 years compared with 37 years for all others; P = 0.005). The most common findings among the 68 patients with posterior segment disease were vitritis (69%); choroidal "punched-out" lesions (56%); "snowball" lesions (46%); cystoid macular edema (CME; 31%); and periphlebitis, vitreous opacity, and posterior vitreous detachment (29% each). There was a significantly higher prevalence of "punched-out" lesions and CME in whites (79% and 54%, respectively) compared with blacks (43% and 18%, respectively; P = 0.005 each). Additionally, the prevalence of CME was highest in white females (61%) compared with all others (20%; P = 0.002). Patients with vitreous hemorrhage were more likely to be in the youngest age group (P = 0.02). Female patients with posterior segment disease had a significantly lower visual acuity compared with males in both the better (P<0.001) and worse (P = 0.002) eye. Conclusions: We have identified variations based on patient race, sex, and age in PSI, specific posterior segment signs, and visual acuity in cases of ocular sarcoidosis.