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Choroidal granulomas in systemic sarcoidosis
U R Desai1, K A Tawansy, B C Joondeph
1Eye Care Services, Henry Ford Health Sciences Center, Detroit, Michigan 48202, USA.
Retina (Philadelphia, Pa.)
|February 24, 2001
Summary
Systemic sarcoidosis can cause choroidal granulomas that respond well to oral corticosteroids. While recurrences may happen, good vision is typically maintained with treatment.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Systemic sarcoidosis is an idiopathic multisystem inflammatory disease.
- Choroidal granulomas are a rare ocular manifestation of systemic sarcoidosis.
- Understanding their clinical course and treatment response is crucial for patient management.
Observation:
- A retrospective study reviewed nine patients with macular and peripapillary choroidal granulomas secondary to systemic sarcoidosis.
- Patients underwent comprehensive ocular examinations, including fundus photography and angiography.
- Magnetic resonance imaging (MRI) was used to assess for intracranial involvement.
Findings:
- All patients exhibited pulmonary involvement consistent with sarcoidosis.
- Choroidal granulomas responded well to oral corticosteroid therapy, with decreased size observed in all treated patients.
- Recurrences were noted in five patients, with a mean time to recurrence of 7.6 months after discontinuing prednisone.
- Final visual acuity was good (20/30 or better) in all patients, despite initial visual disturbances in eight.
Implications:
- Oral corticosteroids are an effective treatment for choroidal granulomas in systemic sarcoidosis.
- Long-term monitoring is necessary due to the potential for recurrence.
- Choroidal granulomas in sarcoidosis are not typically associated with anterior uveitis or intracranial granulomas.