Choroidal Granulomas in Systemic Sarcoidosis

Abstract

Choroidal granulomas related to systemic sarcoidosis respond well to oral corticosteroids. They may recur but good vision can be maintained. They are not typically associated with concomitant iritis and also do not appear to be associated with intracranial granulomas.

Choroidal granuloma as an initial manifestation of systemic sarcoidosis

“…The role of serum angiotensin-converting enzyme in the diagnosis of sarcoid choroidal granuloma, and the subsequent drop in the levels after steroid therapy, has been found to correlate well with flattening of the lesion in previous studies, and this indeed was the finding in our case [10].…”

“…It has been stated by Desai et al [10] that, unless there is macular or optic nerve involvement, choroidal granuloma due to sarcoidosis may go unnoticed. Even though the visual outcome in these cases is good, the importance of diagnosing the solitary choroidal granuloma as a manifestation of ocular sarcoidosis cannot be underestimated, because patients with posterior segment disease have been shown to have twice the incidence of CNS involvement when compared with the whole population of patients with sarcoidosis [6,8].…”

A Complicated Case of Sarcoidosis

“…In contrast, sarcoid uveitis, while being granulomatous, is more commonly associated with a choroiditis. 3 Also of note in this patient was the finding of superficial retinal precipitates overlying the retinitis ( Figure 1B and C). This occurrence has been previously described in the literature in patients with syphilitic retinitis.…”

Unilateral solitary choroidal granuloma as presenting sign of secondary syphilis

“…Granulomatous ocular inflammation can be classified by infectious and noninfectious etiologies. Infections which have been shown to cause granulomatous inflammation include viral, bacterial, and fungal organisms [8][9][10], and anti-infective therapy could be curative. It is crucial to be able to ensure that infection-associated uveitic diseases are recognized early, as unintended consequences of immunosuppressive therapy here could be devastating.…”