Historical transition of management of sarcoidosis

Table 1 Guidelines for diagnosis of ocular sarcoidosis

Infiltrates in anterior chamber: granulomatous (mutton-fat keratic precipitates/iris nodules)

Trabecular meshwork nodules and/or tent-shaped peripheral anterior synechiae

A mass of vitreous opacities (snowball or string of pearls-like appearance)

Retinal perivasculitis (mainly periphlebitis) with perivascular nodules

Multiple candle-wax type chorioretinal exudates and nodules and/or laser photocoagulation spots-like chorioretinal atrophy

Optic disc nodule(s)/granuloma(s) and/or solitary choroidal nodule

Table 2 Expert consensus recommendations on criteria for the diagnosis of cardiac sarcoidosis

Histological diagnosis from myocardial tissue

Cardiac sarcoidosis is diagnosed in the presence of non-caseating granuloma on histological examination

of myocardial tissue with no alternative cause identified (including negative organismal stains if applicable)

Clinical Diagnosis from Invasive and Non-Invasive Studies:

There is a histological diagnosis of extra-cardiac sarcoidosis and

One or more of following is present

Steroid ± immunosuppressant responsive cardiomyopathy or heart block

Unexplained reduced left ventricular ejection fraction (< 40%)

Unexplained sustained (spontaneous or induced) ventricular tachycardia

Mobitz type II 2nd degree heart block or 3rd degree heart block

Patchy uptake on dedicated cardiac PET (in a pattern consistent with cardiac sarcoidosis)

Late Gadolinium Enhancement on cardiovascular magnetic resonance (in a pattern consistent with cardiac sarcoidosis)

Positive gallium uptake (in a pattern consistent with cardiac sarcoidosis)

Other causes for the cardiac manifestation(s) have been reasonably excluded

PET: Positron-emission tomography.