Sarcoidosis eye risks vary by racial group, study finds
Black patients face higher risk of nerve damage, inflammation in front of eye
Written by |
Black/African American people with sarcoidosis are more likely than non-Hispanic white patients to develop certain eye problems, including inflammation in the front of the eye and nerve damage, a study shows.
In contrast, white sarcoidosis patients were found to have a higher risk of inflammation in the back part of the eye. Data also showed that Black people presenting with eye inflammation were more likely to be diagnosed with sarcoidosis in the following three months than their white counterparts.
The study, “Comparing the risk of ocular inflammation secondary to sarcoidosis between non-Hispanic White population and Black/African American population,” was published in the Canadian Journal of Ophthalmology.
Up to 55% of sarcoidosis patients develop eye-related manifestations
Sarcoidosis is characterized by the formation of small clumps of inflammatory cells, called granulomas, in various tissues and organs, which can affect their function. In the U.S., the highest rate of new sarcoidosis cases per year is observed in non-Hispanic Black individuals, with nearly 17.8 cases per 100,000 individuals, compared with 8.3 new cases per 100,000 people overall.
“Roughly 10% [to] 55% of patients with sarcoidosis develop ophthalmic [eye-related] manifestations, but even within the eye, the pattern of disease has been known to vary,” the researchers wrote, adding that some studies suggest that Black race may be a risk factor for eye inflammation.
In this study, a pair of researchers at Virginia Commonwealth University in the U.S. aimed to assess the risk of three types of eye inflammation among non-Hispanic white and Black/African American sarcoidosis patients.
To do so, they retrospectively analyzed data from TriNetX, a global research database featuring unidentifiable health records from more than 275 million people.
Understanding the risks of “inflammation, and optic neuropathy among these [two groups] will help inform clinical decision-making when evaluating these patients for ophthalmic complications,” the researchers wrote. Optic neuropathy refers to damage to the optic nerve, which relays signals from the eye to the brain.
Reserachers targeted a trio of eye conditions
The three eye conditions analyzed were anterior uveitis, or inflammation of the iris (the pigmented part at the front of the eye): chorioretinal inflammation, which affects the retina (the light-sensitive layer at the back of the eye) and the neighboring choroid (a thin layer of tissue in the middle layer of the eye wall); and optic neuritis, or inflammation of the optic nerve.
Researchers identified a total of 57,226 non-Hispanic whites and 39,901 black/African Americans diagnosed with sarcoidosis in the past decade. After matching patients as closely as possible for age and sex, 39,604 patients (mean age 54.6 years; 64% women) were included in each group.
Black/African American patients had a significantly higher incidence, or rate, of new cases of anterior uveitis (4.72% vs. 3%) and optic neuropathy (1.67% vs. 1.36%), while non-Hispanic white patients had a significantly higher incidence of chorioretinal inflammation (1.04% vs. 0.78%).
[These findings show that Black/African American people] newly diagnosed with ocular inflammation are more likely to be diagnosed with sarcoidosis compared with their [non-Hispanic white] counterparts.
This translated into a lower risk of developing anterior uveitis (by 36.4%) and optic neuropathy (by 18.5%) among non-Hispanic white patients, who had a higher risk, by 32.7%, of developing chorioretinal inflammation.
“The results suggest an increased risk for anterior uveitis and optic neuropathy among the [Black/African American] population and an increased risk for chorioretinal inflammation in the [non-Hispanic white] population,” the researchers wrote.
The researchers then analyzed the incidence of sarcoidosis in non-Hispanic whites and black/African Americans presenting with eye inflammation in the past decade.
After adjusting participants for age and sex, the analyses showed that non-Hispanic whites with anterior uveitis were significantly less likely, by 54.9%, to be diagnosed with sarcoidosis in the following three months than their Black/African American counterparts.
Similar results were seen for the other types of eye inflammation, with non-Hispanic whites with chorioretinal inflammation or optic neuropathy being 60.6% to 71.2% less likely to be diagnosed with sarcoidosis.
These findings show that Black/African American people “newly diagnosed with ocular inflammation are more likely to be diagnosed with sarcoidosis compared with their [non-Hispanic white] counterparts,” the scientists wrote. “Further studies should be performed to analyze the effects of gender, socioeconomic, and environmental factors on the development of ocular inflammation in patients with sarcoidosis.”
