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OCULAR SARCOIDOSIS MASQUERADING AS ACUTE RETINAL NECROSIS: TWO CASE REPORTS
Hsin-Ming Liu1, Yung-Jen Lai1,2, Fang-Yi Chiu1
1Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan ; and.
Retinal Cases & Brief Reports
|July 19, 2024
Summary
Ocular sarcoidosis (OS) can rarely mimic acute retinal necrosis with unilateral peripheral retinal infiltration. Chest CT scans aid diagnosis when other tests are negative, with corticosteroid treatment improving vision.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Ocular sarcoidosis (OS) is a multisystem granulomatous disease.
- OS can present with diverse ocular manifestations.
- Early diagnosis and treatment are crucial for visual prognosis.
Purpose of the Study:
- To describe two cases of ocular sarcoidosis (OS).
- These cases initially presented as unilateral acute retinitis.
- The presentation mimicked acute retinal necrosis.
Main Methods:
- Retrospective descriptive case reports.
- Diagnostic evaluations included blood work, anterior chamber paracentesis PCR, and chest imaging.
- Diagnosis was confirmed using the 2017 revised international workshop on OS (IWOS) criteria.
Main Results:
- Two women presented with unilateral vision loss and peripheral retinal infiltration.
- Initial workup and antiviral therapy were ineffective.
- Chest CT revealed lymphadenopathy consistent with sarcoidosis, leading to diagnosis and treatment with corticosteroids.
- Vision improved to 20/25 in both cases after treatment.
Conclusions:
- Acute unilateral peripheral retinal infiltration mimicking acute retinal necrosis can be a rare presentation of OS.
- Chest CT is valuable for diagnosing OS, especially with non-specific systemic findings.
- Prompt diagnosis and systemic corticosteroid treatment are effective for this presentation of OS.
