Abstract
We studied a usefulness and validity of the Japanese guideline for diagnosis of ocular sarcoidosis and the diagnostic criteria for sarcoidosis. Guideline for ocular sarcoidosis required 3 or more of 6 ocular findings suggestive of sarcoidosis. Sensitivity of the criteria of the guideline was high, but specificity seemed to be low. Difficulty in diagnosis of sarcoidosis was reconfirmed by our previous study. In 56 patients with ocular sarcoidosis suspect, only 55% of the patients were diagnosed as sarcoidosis by the diagnostic criteria which required positive biopsy or 3 or more of 5 clinical data; increased serum γ-globulin, increased serum lysozyme, positive Ga scan including at least negative PPD test or increased serum angiotensin converting enzyme. Bronchoalveolar lavage study seemed sensitive to diagnose ocular sarcoidosis. Forty-six % of the suspected ocular sarcoidosis with negative clinical data were diagnosed by transbronchial lung biopsy. Ocular sarcoidosis consists of minute lesions, and difficulty in diagnosis may result from inactive or minimal involvement of other organ which can not be detected by routine clinical investigations.
