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[OCULAR SARCOIDOSIS].

Ayat Qassoom1, Eshchar Raviv Sasportas1, Asaf Bar1

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This case study highlights sarcoidosis presenting as bilateral panuveitis without systemic symptoms. Definitive diagnosis was confirmed through skin biopsy and chest CT findings.

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Area of Science:

  • Ophthalmology
  • Immunology
  • Dermatology

Context:

  • A 68-year-old female presented with decreased vision and bilateral panuveitis.
  • Initial workup for infections and lymphoma was negative, with normal angiotensin-converting enzyme (ACE) levels.
  • Ocular sarcoidosis can manifest insidiously, mimicking other conditions.

Purpose:

  • To report a case of sarcoidosis presenting solely with ocular manifestations.
  • To emphasize the diagnostic challenges and the importance of histopathological confirmation.
  • To highlight the role of skin biopsy and chest CT in diagnosing sarcoidosis.

Summary:

  • Bilateral panuveitis developed in a healthy 68-year-old female with no prior systemic or ocular history.
  • Skin lesions and iris nodules appeared after steroid withdrawal, leading to a skin biopsy revealing non-caseating granulomas.
  • Chest CT confirmed bilateral hilar and mediastinal lymphadenopathy, establishing the diagnosis of sarcoidosis.

Impact:

  • This case underscores that sarcoidosis can present with severe ocular inflammation without overt systemic signs.
  • It reinforces the necessity of a comprehensive diagnostic approach, including biopsy and imaging, for atypical sarcoidosis presentations.
  • Early and accurate diagnosis of ocular sarcoidosis is crucial for timely management and prevention of vision loss.