Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Sarcoidosis is a multi-organ system granulomatous disease of unknown origin with an incidence of 1-40/100,000. Though pulmonary manifestations are predominant, ocular morbidity is characteristic. Ocular Sarcoidosis (OS) affects 25-50% of patients with sarcoidosis and can lead to blindness. To date, no studies have sought to determine risk factors for OS.
Methods: A retrospective chart review was conducted at a single institution with inclusion criteria of biopsy-proven sarcoidosis with a duration of >1 year and a documented smoking status. Variables collected were ages at time of diagnosis (of any organ) and at time of chart review, race, sex, smoking status, quantity of tobacco exposure, and presence (or history) of OS. Disease duration is defined as the difference of age at diagnosis and age time of chart review. Group comparisons were done by t-test and by Mann-Whitney tests where applicable. Univariate and multivariate regression analysis were done to identify independent risk factors.
Results: Of 269 charts reviewed, 109 patients met inclusion criteria. Characteristics of patients with and without OS are shown in table 1. In the OS group, the portion of smokers (71.4%) was significantly higher than in the group without OS (42.0%, p=0.027). There was no significant difference (p=0.605) in the median number of pack years between smokers with OS (13 [7, 28]) and those without OS (16.5 [7, 25]). Furthermore, the OS group consisted of more male patients (57.1% versus 26.1%, p=0.009). Median disease duration of sarcoidosis was also higher in patients with OS (10 years versus 4 years, p=0.031).
Through multivariate regression analysis, tobacco exposure (OR=5.24, p=0.007, 95% CI 1.58-17.41) and male sex (OR=7.48, p=0.002, 95% CI 2.152-26.006) were found to be independent risk factors for the development of OS.
Conclusion: Male sex and tobacco exposure (regardless of pack years) are independent risk factors for development of OS. Disease duration did not withstand multivariate analysis in this moderately sized group. However, screening for OS should not remit in patients with known sarcoidosis until defined in larger prospective populations.
Table 1: Characteristics of patients with and without OS
|
No OS (n=88)
|
With OS (n=21)
|
p-value
|
||||
|
Sex
|
Female
|
65 |
(73.9%) |
9 |
(42.9%) |
0.009 |
|
Male
|
23 |
(26.1%) |
12 |
(57.1%) |
||
|
Age at onset of sarcoidosis (median, IQR)
|
41 |
(35, 49) |
43 |
(33, 49) |
0.863 |
|
|
Disease duration (median, IQR)
|
4 |
(2, 12) |
10 |
(4,15) |
0.031 |
|
|
Race
|
Black
|
78 |
(88.6%) |
19 |
(90.5%) |
1.000 (black vs. all other)
|
|
White
|
5 |
(5.7%) |
0 |
|||
|
Hispanic
|
0 |
1 |
(4.8%) |
|||
|
Middle Eastern
|
1 |
(1.1%) |
0 |
(0.0%) |
||
|
Unknown
|
4 |
(4.5%) |
1 |
(4.8%) |
||
|
Smoking Status
|
Never smoker
|
51 |
(58.0%) |
6 |
(28.6%) |
0.027 |
|
Ever smoker
|
37 |
(42.0%) |
15 |
(71.4%) |
||
|
Pack years of ever smokers (median; IQR)
|
13 |
(7, 28) |
16.5 |
(7, 25) |
0.605 |
|
Disclosure:
A. Janot,
None;
D. Huscher,
None;
M. Walker,
None;
H. K. Grewal,
None;
M. Yu,
None;
M. R. Lammi,
None;
L. A. Saketkoo,
None.
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