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Gallium scan in diagnosing ocular sarcoidosis
Shatriah Ismail1, Zunaina Embong, Wan Hazabbah Wan Hitam
1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
The Malaysian Journal of Medical Sciences : MJMS
|May 19, 2012
Summary
Ocular sarcoidosis, a rare inflammatory condition, can affect the optic nerve and lacrimal gland. This case highlights the diagnostic utility of Gallium scans in identifying this condition.
Area of Science:
- Ophthalmology
- Immunology
- Radiology
Background:
- Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
- Ocular involvement is common in sarcoidosis, affecting various ocular structures.
- Optic nerve and lacrimal gland involvement can present diagnostic challenges.
Observation:
- A 40-year-old male presented with a month of blurred vision and floaters in the right eye.
- Ophthalmic examination revealed optic disc swelling, vitritis, and a granulomatous lesion.
- B-Scan ultrasound showed an optic nerve head lesion; Gallium scan revealed increased lacrimal gland uptake and the 'Panda sign'.
Findings:
- Diagnosis of ocular sarcoidosis was established based on clinical presentation and imaging.
- Serum Angiotensin Converting Enzyme (ACE) levels were normal, underscoring the need for comprehensive diagnostics.
- Conjunctival biopsy confirmed inflammatory cell presence.
Implications:
- This case emphasizes the importance of considering sarcoidosis in the differential diagnosis of optic nerve head lesions.
- Gallium scintigraphy is a valuable tool for diagnosing ocular sarcoidosis, particularly when lacrimal gland involvement is suspected.
- Early diagnosis and management of ocular sarcoidosis are crucial to prevent vision loss.
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