{"id":2125,"date":"2019-08-01T20:21:52","date_gmt":"2019-08-01T20:21:52","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=1731"},"modified":"2026-01-30T19:57:26","modified_gmt":"2026-01-30T19:57:26","slug":"ocular-sarcoidosis","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/ocular-sarcoidosis\/","title":{"rendered":"IWOS Criteria for the Diagnosis of Ocular Sarcoidosis (OS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Sarcoidosis is a systemic inflammatory disorder with unknown aetiology, affecting many organs including the eye and characterised by non-caseating granulomas.<!--more--><\/p>\n<p><strong>Revised International Workshop on Ocular Sarcoidosis (IWOS) criteria for the diagnosis of ocular sarcoidosis (OS)<\/strong><\/p>\n<p>I. Other causes of granulomatous uveitis must be ruled out.<br \/>\nII. Intraocular clinical signs suggestive of OS.<\/p>\n<ol>\n<li>Mutton-fat keratic precipitates (large and small) and\/or iris nodules at pupillary margin (Koeppe) or in stroma (Busacca).<\/li>\n<li>Trabecular mesh work nodules and\/or tent-shaped peripheral anterior synechia.<\/li>\n<li>Snowballs\/string of pearls vitreous opacities.<\/li>\n<li>Multiple chorioretinal peripheral lesions (active and atrophic).<\/li>\n<li>Nodular and\/or segmental periphlebitis (candle wax drippings) and\/or macroaneurysm in an inflamed eye.<\/li>\n<li>Optic disc nodule(s)\/granuloma(s) and\/or solitary choroidal nodule.<\/li>\n<li>Bilaterality (assessed by ophthalmological examination including ocular imaging showing subclinical inflammation).<\/li>\n<\/ol>\n<p>III. Systemic investigation results in suspected OS.<\/p>\n<ol>\n<li>Bilateral hilar lymphadenopathy (BHL) by chest X-ray and\/or chest computed CT scan.<\/li>\n<li>Negative tuberculin test or interferon-gamma releasing assays.<\/li>\n<li>Elevated serum angiotensin-converting enzyme (ACE).<\/li>\n<li>Elevated serum lysozyme.<\/li>\n<li>Elevated CD4\/CD8 ratio (&gt;3.5) in bronchoalveolar lavage fluid.<\/li>\n<li>Abnormal accumulation of gallium-67 scintigraphy or 18F-fluorodeoxyglucose positron emission tomography imaging.<\/li>\n<li>Lymphopenia.<\/li>\n<li>Parenchymal lung changes consistent with sarcoidosis, as determined by pulmonologists or radiologists.<\/li>\n<\/ol>\n<p>IV. Diagnostic criteria.<\/p>\n<ul>\n<li>Definite OS: diagnosis supported by biopsy with compatible uveitis.<\/li>\n<li>Presumed OS: diagnosis not supported by biopsy, but BHL present with two intraocular signs.<\/li>\n<li>Probable OS: diagnosis not supported by biopsy and BHL absent, but three intraocular signs and two systemic investigations selected from two to eight are present.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Mochizuki M, Smith JR, Takase H, Kaburaki T, Acharya NR, Rao NA; International Workshop on Ocular Sarcoidosis Study Group. Revised criteria of International Workshop on Ocular Sarcoidosis (IWOS) for the diagnosis of ocular sarcoidosis.\u00a0Br J Ophthalmol. 2019 Feb 23. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30798264\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Yang SJ, Salek S, Rosenbaum JT. Ocular sarcoidosis: new diagnostic modalities and treatment.\u00a0Curr Opin Pulm Med. 2017 Sep;23(5):458-467. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28622198\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Rosenbaum JT, Pasadhika S. Ocular Sarcoidosis. Clin Chest Med. 2024 Mar;45(1):59-70. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38245371\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jul 25, 2019.<br \/>\nUp-date Jan 30, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[127],"tags":[16,15,123,13,129,130,131,128],"class_list":["post-2125","post","type-post","status-publish","format-standard","hentry","category-ophthalmology","tag-criteria","tag-criterios","tag-diagnosis","tag-diagnostico","tag-iwos","tag-ocular","tag-os","tag-sarcoidosis"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2125","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2125"}],"version-history":[{"count":5,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2125\/revisions"}],"predecessor-version":[{"id":10611,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2125\/revisions\/10611"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2125"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2125"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}