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Purpose: To analyze clinical characteristics of ocular sarcoidosis in a group of biopsy-proven sarcoid patients treated at the single referral center for sarcoidosis in Serbia., Methods: A prospective study carried out on 88 biopsy-proven sarcoid patients between January 2012 and December 2014. All patients underwent complete ophthalmological examination., Results: Ocular sarcoidosis was present in 32 patients (36.4% of all) and included: eyelid skin lesions (2.3%); orbital inflammation (2.3%); conjunctival lesions (7.9%); anterior uveitis (2.3%); intermediate uveitis (1.1%); posterior uveitis (15.9%); panuveitis (5.7%), and neuro-ophthalmologic manifestations (9.1%). Complications included cataract (20.4%); glaucoma (5.7%); cystoid macular edema (3.4%); epiretinal membrane formation (4.5%); macular atrophy (2.3%); and choroidal neovascularization (1.1%). Binocular visual impairment was present in one patient (1.1%), due to complications of posterior uveitis (macular scars)., Conclusions: Patients in Serbia demonstrated ocular sarcoidosis as the first most common site of extrapulmonary sarcoid manifestations, with more often neuro-ophthalmologic lesions than in other European populations.

Evaluation of the health-related quality of life (HRQoL) in patients with respiratory diseases has been increasingly included into regular clinical studies, and HRQL in sarcoidosis has been evaluated since not a long ago. The aim of the study was to evaluate HRQoL in patients with sarcoidosis regarding gender differences, pre and after therapy. We investigated 202 pathohistologically verified sarcoidosis patients (154 female and 48 male) without comorbidities. HRQL was assessed by the disease-specific Sarcoidosis Health Questionnaire (SHQ), which contains 29 items, and cover three domains: everyday functioning, physical activities and emotional state. Total score, as well as the scores for each SHQ domains were calculated. HRQoL was estimated pre and after three months of therapy. At the study start, the lowest score value for the whole group was reported in SHQ emotional state domain (4.24), and the highest in domain of physical functioning (4.7). After three months, the lowest values were reported in domain of everyday activities, while the highest scores were found in emotional domain; all SHQ scores increased, but reached the statistical significance only in the everyday functioning and the physical activities domains. Analyzing mean SHQ scores in male and female sarcoidosis pts before therapy we found high statistically lower emotional and total score in female pts, as well as lower physical score. After the three months therapy we found high statistical difference in physical domain (i.e. women had lower physical score than men). Female sarcoidosis pts showed lower emotional, physical and total score before therapy. After the three-month therapy we found that women had lower physical score than men. SHQ showed good measurement properties both in the cross-sectional and longitudinal assessment of sarcoidosis patients.

Recently published data indicate that vitamin D abnormalities are common in sarcoidosis patients. The purpose of this study was to compare serum vitamin 25(OH)D levels among sarcoidosis patients with different clinical courses of the disease. The study also included the first observations on cognitive functions (i.e. depression and fatigue syndrome) in relation to vitamin D deficiency in sarcoidosis patients. At the Biochemical Laboratory of the Clinical Center of Serbia, Belgrade, vitamin D25(OH)D was measured using the Elecsys® Vitamin D total test. A total of 226 patients with biopsy-positive sarcoidosis were analyzed. The average median value of serum vitamin D was 9.47 mg/L, suggesting severe deficiency. Statistically significant correlation was found in patients with chronic disease and low levels of serum vitamin 25(OH)D (Chi-Square=6.044; df=2; p=0.014). The patient group with vitamin D serum levels higher than 20 mg/L showed higher levels of the mean forced vital capacity (FVC) by 380 mL, and forced expiratory volume in one second (FEV1) by 220 mL, when compared to the patient group with lower serum vitamin D. A statistically significant role was established for serum vitamin 25(OH)D levels as the predictor of fatigue (R2=0.878; p=0.038 (b=0.216)) and depression in patients with sarcoidosis (R2=0.80; p=0.000 (b=0.391)). The insufficiency of 25(OH)D seems to be an important factor in predicting the course of chronic disease, significant lung function impairments and cognitive failures such as fatigue and depression. The fact that the majority of the analyzed sarcoidosis patients had totally deficient serum 25(OH)D levels made this finding even more notable.