Sarcoid Uveitis Epidemiology, Systemic Treatment, and Complications: A Large United States National Database Study

To determine the epidemiology of sarcoidosis and sarcoid uveitis and the investigations, systemic treatments, and complications of sarcoid uveitis on a population level. We performed a retrospective cohort study using the TriNetX United States Collaborative Network to identify cases using the International Classification of Diseases, 10th Revision (ICD-10) codes. We calculated the incidence and prevalence of sarcoidosis in our cohort and uveitis in sarcoidosis patients per 100,000 persons from 2013 to 2025. We assessed the management pathways and the ocular complication rates in sarcoid uveitis patients. Among 108,597,869 patients, 146,356 had sarcoidosis, and 5,609 had sarcoid uveitis, with mean ages of 62.6 years and 58.8 years, respectively, and female predominance in both cohorts (56.5–60.4%). Most sarcoidosis patients were White (53.4%), while the majority of sarcoid uveitis patients were Black or African American (43.68%). Almost 4% of patients with sarcoidosis developed uveitis within 5 years, and the incidence of uveitis in sarcoidosis patients remained relatively constant, while the prevalence of both sarcoidosis in our cohort and uveitis in sarcoidosis patients increased in our study period. In sarcoid uveitis patients, the most common investigative and treatment modalities were chest X-ray (41%) and glucocorticoids (44%), respectively, and the most common ocular complications within 5 years of sarcoid uveitis diagnosis were cataract (35.7%), glaucoma (30.6%), cystoid macular edema (16.1%), and low vision and blindness (10.2%). Sarcoidosis prevalence rose over 12 years, but uveitis rates remained stable. One-third of sarcoid uveitis patients developed major ocular complications, highlighting the disease burden.