Herbort et al reported criteria for the diagnosis of ocular sarcoidosis formulated at the First International Workshop on Ocular Sarcoidosis (IWOS). The diagnosis is based on a number of clinical signs and laboratory investigations. The authors are from multiple institutions from around the world.

Patient selection: possible ocular sarcoidosis (OS)


Clinical signs:

(1) mutton-fat KP (keratic precipitates) and/or iris nodules (at pupillary margin or in stroma)

(2) trabecular meshwork nodules and/or tent-shaped peripheral anterior synechiae

(3) vitreous opacities, snowballs or string of pearls

(4) multiple chorioretinal peripheral lesions (active and atrophic)

(5) nodular and/or segmental peri-phlebitis (with or without candlewax drippings) and/or macroaneurysm in an inflamed eye

(6) optic disc nodules(s)/ granuloma(s) and/or solitary choroidal nodule

(7) bilateral findings


Laboratory investigations:

(1) negative tuberculin skin test in a BCG vaccinated patient or in a patient with a previously positive tuberculin or Mantoux skin test

(2) elevated serum angiotensin converting enzyme (ACE) OR elevated serum lysozyme

(3) bilateral hilar lymphadenopathy on chest X-ray

(4) abnormal liver function tests (2 or more of: AST, ALT, LDH, GGT or alkaline phosphatase)

(5) findings suggestive of sarcoidosis on chest CT scan (performed if chest X-ray negative)

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