Retinal Granulomas in Ocular Sarcoidosis: An Under-recognized Phenomena
Purpose
Aim of our study is to report a clinical series of patients with ocular sarcoidosis who presented or developed retinal granulomas
Methods
10 patients with ocular sarcoidosis were included in the study. We retrospectively reviewed and analyzed through multimodal-imaging (OCT, FA, Fundus photography) data of the retinal infiltrates, from the presentation to follow up to demonstrate lesions progression
Results
All patients had a diagnosis of ocular sarcoidosis (IWOS criteria: definitive, presumed, or probable) and bilateral ocular involvement (100%). Intraocular signs suggestive of ocular sarcoidosis included granulomatous keratic precipitates, tent-shaped peripheral anterior synechia, vitreous opacities, retinal periphlebitis, and retinal microaneurysms. Chorioretinal infiltrates appeared as yellowish lesions on color fundus photography in the active phase; OCT scans corresponding to chorioretinal infiltrates showed focal full thickness hyper-reflective lesions of the outer retina in most of the cases and associated with interruption of retinal pigment epithelium; retinal thickness in the area of the lesions was increased. Preretinal infiltrates were also noted. Choroidal lesions were also frequently associated with retinal lesions. Follow-up of lesions showed regression with retinal atrophy
Conclusion
Granulomas in ocular sarcoidosis are often thought to have a choroidal localization. OCT imaging through peripheral granulomas is usually not performed and retinal infiltrates may be under-recognized. Our photo series demonstrates that peripheral granulomas on examination can be localized in the choroid, retina, or both. Progression of these lesions often leads to retinal and retinal pigmented epithelium atrophy.
Conflict of interest
No
Authors 1
Last name
RISSOTTO
Initials of first name(s)
F
Department
Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute San Raffaele,
City
Milan
Country
Italy
Authors 2
Last name
Miserocchi
Initials of first name(s)
E
Department
Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute San Raffaele,
City
Milano
Country
Italy
Authors 3
Last name
Goldstein
Initials of first name(s)
D
Department
Department of Ophthalmology, Northwestern University Feinberg School of Medicine
City
Chicago
Country
United States
Authors 4
Last name
Zicarelli
Initials of first name(s)
F
Department
Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan,
City
Milan
Country
Italy
Authors 5
Last name
Invernizzi
Initials of first name(s)
A
Department
Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan,
City
Milan
Country
Italy
Authors 6
Last name
Pichi
Initials of first name(s)
F
Department
Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates;
City
Abu Dhabi
Country
United Arab Emirates
Authors 7
Last name
Marchese
Initials of first name(s)
A
Department
Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute San Raffaele,
City
Milan
Country
Italy
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