Sarcoidosis is a multisystem disease of unclear etiology with a variable clinical profile characterized by the presence of non-caseating granuloma in involved organs.
Methods
We describe the clinical case of a 63-year-old male patient with bilateral ocular sarcoidosis.
Results
A 63-year-old patient, with irrelevant systemic and ocular history was observed in the ophthalmology department due to sudden bilateral visual loss, allied to red eyes and photophobia, with a week of evolution.
He presented a best corrected visual acuity (BCVA) of 2/10 in each eye. In the anterior segment, there were cells 3+ (SUN criteria), granulomatous keratic precipitates and posterior synechiae, in both eyes. Intra-ocular pressure was 12 mmHg, in each eye. Fundus examination showed marked vitritis and multifocal yellow-white choroidal infiltrates. The patient performed optical coherence tomography that showed macular oedema, in the left eye. Chest Computed tomography revealed bilateral hilar lymphadenopathy. Serum angiotensin converting enzyme level was raised. Patient was treated with subconjunctival dexamethasone, topical dexamethasone and oral prednisolone (1mg/Kg/day). There was favorable clinical evolution but the patient developed steroid dependency and three months after, he started methotrexate (MTX, 0.3 mg/kg/week). One month after, macular oedema was present in the left eye and was treated with dexamethasone intravitreal implant (DII, Ozurdex). Four months after, the oedema had return and he performed another DII. Five months after, due to macular edema he performed fluocinolone acetonide intravitreal implant (FA, Iluvien), with no recurrence during the 18 months of follow up.
Conclusion
At 18 months of follow up after FA, he presented BCVA of 8/10 in each eye.
Conflict of interest
No
Authors 1
Last name
FERREIRA
Initials of first name(s)
C
Department
Ophthalmology Department, Centro Hospitalar Sao Joao
City
Porto
Country
Portugal
Authors 2
Last name
Costa
Initials of first name(s)
S
Department
Ophthalmology Department, Centro Hospitalar Sao Joao
City
Porto
Country
Portugal
Authors 3
Last name
Figueira
Initials of first name(s)
L
Department
Ophthalmology Department, Centro Hospitalar Sao Joao
City
Porto
Country
Portugal
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