The Probability of Detecting Sarcoidosis in Uveitis Patients with Intermittent Tattoo Swelling: A Retrospective Analysis

PURPOSE: To determine the probability of detecting sarcoidosis in uveitis patients with intermittent tattoo swelling. METHODS: A retrospective cohort study completed at single tertiary referral academic institution. Inclusion criteria included a diagnosis of non-infectious uveitis, presence or absence of at least one tattoo, and age over 18 years old. Patients with unknown history of tattoo swelling and those with traumatic, infectious and neoplastic causes of uveitis were excluded. Based upon International Workshop on Ocular Sarcoidosis (IWOS) revised criteria, patients were classified as definite, presumed, and probable sarcoidosis. RESULTS: We identified 338 patients with known tattoo presence or absence. The presence of tattoos was noted in 170 (50.3%) and of the 153 in which tattoo swelling status was queried; 43 reported intermittent swelling (28.1%). Anterior uveitis was the common uveitis subtype in the total cohort (37.4%), while panuveitis was the most common uveitis subtype noted in patients with tattoo swelling (18/43, 41.9%). Of the 43 with tattoo swelling, sarcoidosis was the most frequently identified systemic disease associated with uveitis (34.9%). Among those 15 patients with sarcoidosis, 10 were considered definite, 1 was considered presumed, and 4 were labeled as probable. Following sarcoidosis, the most common etiologies were idiopathic uveitis in the setting of completed chest computed tomography imaging (32.6%), HLA-B27 associated uveitis (11.6%), and Behçet's disease (4.7%). CONCLUSION: Patients with uveitis should be queried on tattoo presence and whether or not they intermittently swell. A sarcoidosis workup including computed tomography of the chest should be considered for these patients.