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Taches de bougie

T R Vrabec1, J J Augsburger, D H Fischer

  • 1Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.

Ophthalmology
|November 1, 1995
PubMed
Summary
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Posterior segment lesions like taches de bougie can indicate sarcoidosis, often mistaken for birdshot chorioretinopathy (BCR) or multifocal choroiditis (MFC). Early diagnosis is key for better visual prognosis in these sarcoidosis patients.

Area of Science:

  • Ophthalmology
  • Rheumatology
  • Immunology

Background:

  • Posterior segment ocular lesions, such as taches de bougie, can be an initial manifestation of sarcoidosis.
  • These lesions may be misdiagnosed as birdshot chorioretinopathy (BCR) or multifocal choroiditis (MFC) in cases of unrecognized sarcoidosis.

Observation:

  • A retrospective study identified 22 patients with taches de bougie and sarcoidosis, confirmed by noncaseating granulomas in 17 via biopsy.
  • Two distinct patterns of taches de bougie were observed: peripheral spots resembling MFC and posterior streaks similar to BCR.

Findings:

  • Peripheral spots were seen in 73% of patients, while 27% exhibited posterior streaks, which correlated with a better visual prognosis.
  • Systemic sarcoidosis markers like chest x-ray, serum angiotensin-converting enzyme, and gallium scan showed variable results, with some patients presenting normal findings.

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Implications:

  • Sarcoidosis should be considered in the differential diagnosis for patients presenting with fundus findings suggestive of BCR or MFC.
  • Diagnostic workup should include chest x-ray and angiotensin-converting enzyme levels, with further investigations like gallium scans or biopsies considered based on clinical presentation and age.