Remission in sarcoid uveitis: identification of predictive factors

Objective To identify predictive factors of remission in patients with sarcoid uveitis and to evaluate recurrence rates and patterns following remission. Methods Multicentre retrospective study of patients with sarcoid uveitis and a minimum follow-up of 3 years. Remission was defined as the absence of clinical symptoms of sarcoidosis for at least 3 years without treatment. Remission-free Kaplan-Meier survival curves were constructed for selected variables. Cox proportional hazards model was then applied. HRs and 95% CIs were estimated for each variable. Statistical significance was set at the p<0.05 level. Rates and patterns of recurrence after remission were collected and compared with initial presentation. Results A total of 329 patients were included (62% female, median age 53 years). Remission occurred in 98 (30%) patients after a median follow-up of 6.5 years. Macular oedema at baseline was associated with a lower likelihood of remission (HR, 0.594, 95% CI 0.342 to 0.996, p=0.043), whereas pulmonary involvement at baseline was associated with a higher likelihood of remission (HR, 1.588, 95% CI 1.047 to 2.419, p=0.032). Recurrence after remission occurred in 6 of 98 patients (6%), with a median time to recurrence of 46 months after remission. At recurrence, patients predominantly had anterior uveitis (83%) and shared similar anatomical patterns with their initial presentation. Conclusions Approximately one in three patients with sarcoid uveitis achieved remission. Macular oedema at baseline was associated with delayed remission, while lung involvement at baseline was associated with faster remission. Recurrence after remission was uncommon and typically mirrored the initial uveitis phenotype.