Retinal granulomas in Weerfordt-Waldenström syndrome: Case report
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Purpose
Sarcoid uveitis usually presents as anterior granulomatous uveitis, retinal vasculitis, or multifocal choroiditis, with rare posterior segment granulomas. This case describes biopsy-proven sarcoidosis manifesting as Weerfordt-Waldenström syndrome with panuveitis and multifocal retinal granulomas. Multimodal imaging, including SD-OCT and angiography, confirmed the diagnosis.
Methods
A 30-year-old woman presented with a three-week history of painless bilateral vision loss, systemic symptoms and facial nerve palsy. A comprehensive ophthalmic examination revealed bilateral anterior granulomatous uveitis, vitritis, and multifocal fundus lesions mainly located in the posterior pole and inferior periphery. The pattern of peripheral lesions was considered to be consistent with multifocal choroiditis. Most lesions involving the posterior pole were located within retina, and SD-OCT highlighted in their location hyperreflective nodular lesions primarily involving the inner retinal layers, with sparing of the retinal pigment epithelium and choroid. A mediastinal lymph node biopsy confirmed non-caseating granulomas, excluding infectious causes.
Results
High-dose corticosteroids resolved inflammation, with retinal granulomas healing and inferior lesions developing chorioretinal atrophy.
Conclusion
Sarcoid ocular involvement may present with multiple small intraretinal granulomas. SD-OCT is highly useful for accurate diagnosis and reliable monitoring of the evolution of retinal granulomas. Additional studies using wide-field OCT scans through peripheral lesions may better characterize sarcoid retinal granulomas
Conflict of interest
No
1
Last name
BERBICH
Initials of first name(s)
Z
Department
Ophtalmoclinic Noor
City
Rabat
Country
Morocco
2
Last name
KSIAA
Initials of first name(s)
I
Department
CHU Fattouma BOURGUIBA
City
Monastir
Country
Tunisia
3
Last name
AHBEDDOU
Initials of first name(s)
S
Department
Ophtalmoclinic Noor
City
Rabat
Country
Morocco
4
Last name
IMANI
Initials of first name(s)
Y
Department
Ophtalmoclinic Noor
City
Rabat
Country
Morocco
5
Last name
BERBICH
Initials of first name(s)
O
Department
Ophtalmoclinic Noor
City
Rabat
Country
Morocco
6
Last name
KHAIRALLAH
Initials of first name(s)
M
Department
CHU Fattouma Bourguiba
City
Monastir
Country
Tunisia
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