Pascal Sève, Thomas El Jammal, Yasmine Serrar, Yvan Jamilloux, Laurent Kodjikian, Robin Jacquot
{"title":"结节病相关性葡萄膜炎:现状及未来展望","authors":"Pascal Sève, Thomas El Jammal, Yasmine Serrar, Yvan Jamilloux, Laurent Kodjikian, Robin Jacquot","doi":"10.1016/j.revmed.2026.05.006","DOIUrl":null,"url":null,"abstract":"<p><p>Sarcoidosis-related uveitis is the most common manifestation of ocular sarcoidosis. It can occur at any age but preferentially affects adults aged 30 to 60 years, with a female predominance, especially in forms with late onset. Suggestive semiological features are: granulomatous anterior uveitis defined by thick retro-descemetal precipitates (so-called \"mutton-fat\" keratic precipitates) or iris nodules, anterior synechiae, vitreous inflammation (hyalitis), periphlebitis, choroidal granulomas, and macular edema. Diagnosis relies on a combination of these ophthalmological features and paraclinical tests, notably serum biomarkers and suggestive chest imaging. Management is guided by the anatomical characteristics of the uveitis - including laterality and the severity of inflammation - as well as associated extra-ophthalmic manifestations and the patient's background. Systemic treatment is offered in case of failure, contraindication or side effects of local corticosteroid therapy, or active bilateral posterior-segment involvement. Conventional immunosuppressive agents, particularly methotrexate, remain first-line therapy. Hydroxychloroquine appears to be a good option for anterior and intermediate uveitis. Biologic agents such as anti-TNFα drugs - especially adalimumab - are used for refractory cases because of their steroid-sparing effect demonstrated for chronic non-anterior non-infectious uveitis. Tocilizumab appears to be an alternative to anti-TNF agents, particularly in patients with macular edema. Multi-omics techniques and artificial intelligence offer prospects for diagnosis, refining prognosis and personalizing therapy for sarcoid uveitis.</p>","PeriodicalId":94122,"journal":{"name":"La Revue de medecine interne","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Sarcoidosis-associated uveitis: Current status and future prospects].\",\"authors\":\"Pascal Sève, Thomas El Jammal, Yasmine Serrar, Yvan Jamilloux, Laurent Kodjikian, Robin Jacquot\",\"doi\":\"10.1016/j.revmed.2026.05.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Sarcoidosis-related uveitis is the most common manifestation of ocular sarcoidosis. It can occur at any age but preferentially affects adults aged 30 to 60 years, with a female predominance, especially in forms with late onset. Suggestive semiological features are: granulomatous anterior uveitis defined by thick retro-descemetal precipitates (so-called \\\"mutton-fat\\\" keratic precipitates) or iris nodules, anterior synechiae, vitreous inflammation (hyalitis), periphlebitis, choroidal granulomas, and macular edema. Diagnosis relies on a combination of these ophthalmological features and paraclinical tests, notably serum biomarkers and suggestive chest imaging. Management is guided by the anatomical characteristics of the uveitis - including laterality and the severity of inflammation - as well as associated extra-ophthalmic manifestations and the patient's background. Systemic treatment is offered in case of failure, contraindication or side effects of local corticosteroid therapy, or active bilateral posterior-segment involvement. Conventional immunosuppressive agents, particularly methotrexate, remain first-line therapy. Hydroxychloroquine appears to be a good option for anterior and intermediate uveitis. Biologic agents such as anti-TNFα drugs - especially adalimumab - are used for refractory cases because of their steroid-sparing effect demonstrated for chronic non-anterior non-infectious uveitis. Tocilizumab appears to be an alternative to anti-TNF agents, particularly in patients with macular edema. Multi-omics techniques and artificial intelligence offer prospects for diagnosis, refining prognosis and personalizing therapy for sarcoid uveitis.</p>\",\"PeriodicalId\":94122,\"journal\":{\"name\":\"La Revue de medecine interne\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2026-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"La Revue de medecine interne\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.revmed.2026.05.006\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"La Revue de medecine interne","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.revmed.2026.05.006","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
[Sarcoidosis-associated uveitis: Current status and future prospects].
Sarcoidosis-related uveitis is the most common manifestation of ocular sarcoidosis. It can occur at any age but preferentially affects adults aged 30 to 60 years, with a female predominance, especially in forms with late onset. Suggestive semiological features are: granulomatous anterior uveitis defined by thick retro-descemetal precipitates (so-called "mutton-fat" keratic precipitates) or iris nodules, anterior synechiae, vitreous inflammation (hyalitis), periphlebitis, choroidal granulomas, and macular edema. Diagnosis relies on a combination of these ophthalmological features and paraclinical tests, notably serum biomarkers and suggestive chest imaging. Management is guided by the anatomical characteristics of the uveitis - including laterality and the severity of inflammation - as well as associated extra-ophthalmic manifestations and the patient's background. Systemic treatment is offered in case of failure, contraindication or side effects of local corticosteroid therapy, or active bilateral posterior-segment involvement. Conventional immunosuppressive agents, particularly methotrexate, remain first-line therapy. Hydroxychloroquine appears to be a good option for anterior and intermediate uveitis. Biologic agents such as anti-TNFα drugs - especially adalimumab - are used for refractory cases because of their steroid-sparing effect demonstrated for chronic non-anterior non-infectious uveitis. Tocilizumab appears to be an alternative to anti-TNF agents, particularly in patients with macular edema. Multi-omics techniques and artificial intelligence offer prospects for diagnosis, refining prognosis and personalizing therapy for sarcoid uveitis.