Background: Tuberculosis (TB) and sarcoidosis are two common granulomatous diseases involving lymph nodes. Differential diagnosis is not always easy because pathogen demonstration in tuberculosis is not always possible and both diseases share clinical, radiological and histological patterns. The aim of our study was to identify factors associated with each diagnosis and set up a predictive score for TB. Methods: All cases of lymph node tuberculosis and sarcoidosis were retrospectively reviewed. Demographics, clinical characteristics, laboratory and imaging data, and microbiological and histological results were collected and compared. Results: Among 441 patients screened, 192 patients were included in the final analysis. The multivariate analysis showed that weight loss, necrotic granuloma, normal serum lysozyme level and hypergammaglobulinemia were significantly associated with TB. A risk score of TB was built based on these variables and was able to discriminate TB versus sarcoidosis with an AUC of 0.85 (95% CI: 0.79–0.91). Using the Youden’s J statistic, its most discriminant value (−0.36) was associated with a sensitivity of 80% and a specificity of 75%. Conclusions: We developed a score based on weight loss, necrotic granuloma, normal serum lysozyme level and hypergammaglobulinemia with an excellent capacity to discriminate TB versus sarcoidosis. This score needs still to be validated in a multicentric prospective study.

Purpose: To define a timeframe of recurrences according to the clinical presentation of inflammation and the course of the disease. This could influence final visual acuity and avoid ocular complication such as cataract, glaucoma, choroidal neovascularization, subretinal fibrosis or fundus depigmentation. Materials and methods: Retrospective study of nineteen patients affected by Vogt-Koyanagi-Harada disease followed between 2003 and 2018. Results: Within our case series, 53% of patients had no recurrence during a follow-up of up to one hundred and sixty-eight months. Among the nine patients with recurrence, five had at least one episode of posterior inflammation, one exhibited both anterior and posterior recurrence, and five developed at least one recurrence in anterior structures. According to the Kaplan Meier method, the overall recurrence-free survival at three months is 68% ± 11%. All posterior segment inflammatory relapses occurred within three months and a half of systemic treatment initiation. On the other hand, the timeline of anterior recurrence is more scattered. They occurred between two and thirty-seven months of treatment initiation. This careful follow-up, which differentiated between types of inflammatory recurrences, made it possible to observe final visual acuity greater than or equal to 9/10 (equivalent ≥ 20/25), with the exception of one amblyopic eye. Conclusion: The chronological occurrence of posterior inflammatory episodes is earlier than anteriorly. A posterior recurrence does not increase the risk of anterior inflammation relapse during the follow-up. This distinction is important to understand the course of the disease. In fact, the differentiation between the initial acute phase (mainly posterior inflammations) and chronic recurrences (granulomatous anterior segment inflammation) allows for better adaptation of systemic therapy and better visual prognosis in the long term.

Purpose: to define a timeframe of recurrences according to the clinical presentation of the inflammation and to the course of the disease. This could influence the final visual acuity and avoid ocular complication such as cataract, glaucoma, choroidal neovascularization, subretinal fibrosis or fundus depigmentation. Material and methods: retrospective study of nineteen patients affected of Vogt-Koyanagi-Harada disease followed between 2003 and 2018. Results: within our case series, 53% of our patients had no recurrence during a follow-up up to one hundred and sixty-eight months. Among the nine patients presenting a recurrence, five had at least one episode of posterior inflammation, one exhibited anterior and posterior recurrence, and five developed at least one recurrence in anterior structures. According to the Kaplan Meier’s method, the overall survival without any recurrence at three months is equal to 68% ± 11%. All posterior segment inflammatory relapses occurred within three months and a half of initiation of systemic treatment. On the other hand, the timeline of anterior recurrence is more scattered. They appeared between two and thirty-seven months. This careful follow-up distinguishing the type of inflammatory recurrence made it possible to find final visual acuity greater than or equal to 9/10 (equivalent ≥ 20/25), with the exception of one amblyopic eye. Conclusion: The chronological occurrence of inflammatory episodes is earlier posteriorly than anteriorly. A posterior recurrence does not expose to a higher risk of anterior inflammation relapse during the follow-up. This distinction is important for understanding understandig the course of the disease. In fact, the differentiation between the initial acute phase (mainly posterior inflammation) and chronic recurrences (granulomatous anterior segment inflammation) allows better adaptation of systemic therapy and better visual prognosis in the long term.

An 87-year-old woman was referred to our ophthalmology ward due to decreased visual acuity and intense right orbital pain, which had been present for four weeks. The anamnesis was not contributory, except that she had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) four weeks prior to symptom onset. Her best-corrected visual acuity was hand movements in the right eye and 20/20 in the left eye. Intra-ocular pressure was 34 mmHg and 16 mmHg, respectively. Right eye slit lamp examination revealed palpebral oedema, chemosis, and temporal scleral thickening with conjunctival injection. The cornea was edematous with endothelial precipitates. The anterior chamber was shallow with a closed angle, associated with grade 1+ cells and 1+ flare, according to the SUN grading system. Mild vitreous inflammation was present (grade 0.5+ vitreous cells), and a total choroidal detachment was visible. In the absence of any other plausible cause, unilateral choroidal effusion with secondary angle-closure due to severe panuveitis was considered a possible adverse event following vaccination against SARS-CoV2.