Highlights
- •Most patients with sarcoidosis (~2/3) complete eye examinations around the time of diagnosis, though many do not.
- •Access to regional ophthalmologists may impact local eye screening rates in sarcoidosis.
- •Sex, age, and immigration status are important factors associated with ophthalmologic screening.
Abstract
Introduction
Consensus guidelines for the management of sarcoidosis recommend screening eye examinations
for all patients, even in those without ocular symptoms. We aimed to determine the
proportion of sarcoidosis patients that complete ophthalmologic evaluations and factors
associated with their performance.
Methods
We identified patients with sarcoidosis using population health services data from
Ontario, Canada between 1991 and 2019. Sarcoidosis was defined by ≥ 2 physician visits
for sarcoidosis within a two-year period. Ophthalmologic evaluations were based on
an optometrist or ophthalmologist visit within the year prior or two years following
the diagnosis. We estimated correlations between the number of eye care professionals
and proportion of sarcoidosis patients completing ophthalmologic assessments within
regional health units. We evaluated for associations between ophthalmologic screening
and patient characteristics using multivariable logistic regression.
Results
We identified 21,679 patients with sarcoidosis in Ontario. An ophthalmologic evaluation
was performed in 14,751 (68.0%), with a similar number of individuals seeing ophthalmologists
and optometrists (43.7% vs. 42.2%). The percentage of sarcoidosis patients undergoing
an ophthalmologic evaluation within corresponding regional health units was moderately
correlated with the number of practicing ophthalmologists (r = 0.64, p = 0.01), but
not the number of optometrists (r = 0.08, p = 0.77). Patients who were older [OR per
year 1.02 (95% CI 1.01–1.02), p < 0.001] and female [OR 1.54 (95% CI 1.44–1.63), p < 0.001]
were more likely to complete ophthalmologic evaluations. Immigrants to Canada were
less likely to undergo ophthalmologic assessments [OR 0.66 (95% CI 0.60–0.73), p < 0.001].
Conclusions
Most patients with sarcoidosis complete ophthalmologic examinations, though a substantial
proportion does not. Young adults, men and immigrants were less likely to complete
ophthalmologic evaluations. Limited access to ophthalmologists may at least in part
explain why some sarcoidosis patients fail to complete ophthalmologic screening.
Keywords
Abbreviations:
ICD-9/10 (International Classification of Diseases, Ninth/Tenth Revision codes), OHIP (Ontario Health Insurance Plan)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 12, 2021
Accepted:
August 10,
2021
Received in revised form:
July 14,
2021
Received:
February 28,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
