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Photo Essay Peripheral choroidal nodules in a case of proven systemic sarcoidosis Vishnu Suryaprakash, Sanghamitra Kanungo, Jyotirmay Biswas A case of sarcoidosis presenting as peripheral choroidal nodules has been described.
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Key words: Sarcoidosis, choroidal nodules, uveitis
Website: www.ijo.in DOI: 10.4103/0301-4738.114105 PMID: ****** Quick Response Code:
A 38-year-old female presented with complaints of floaters in both eyes for the past 7 months. Her best corrected visual acuity was 6/6 OU. Anterior segment OU was normal. Dilated fundus OU showed clusters of yellowish white, round, and subretinal lesions associated with intraretinal hemorrhages more in the superotemporal and inferotemporal fundus. This fundus picture along with bilateral hilar lymphadenopathy
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Figure 2: Fundus fluorescein angiography montage of the right eye (a) and the left eye (b) showing multiple hyperflourescent spots corresponding to the choroidal lesions
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Figure 1: Color fundus photograph montage of the right eye (a) and of the left eye (b) showing clusters of choroidal nodules in the superotemporal and inferior quadrants showing lesions in various stages of activity Department of Uveitis and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, Nungambakkam, Chennai, Tamil Nadu, India Correspondence to: Prof. Dr. Jyotirmay Biswas, Director, Department of Uveitis and Ocular Pathology, Medical Research Foundation, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai – 600 006, Tamil Nadu, India. E-mail:
[email protected] Manuscript received: 15.07.2012; Revision accepted: 28.01.2013
Figure 3: High resolution computed tomography of the chest showing bilateral hilar lymphadenopathy
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Indian Journal of Ophthalmology
as visualized in high resolution computed tomography of the chest clinched the diagnosis of sarcoidosis.
Discussion Sarcoidosis is a chronic multisystemic, granulomatous disease of unknown etiology. Ocular manifestations are common in 25%-50% of patients in histologically proven disease. [1] Although ocular sarcoidosis more commonly presents as an anterior granulomatous uveitis, a wide spectrum of ocular involvement exists. Typical posterior segment findings include vitritis with or without inflammatory “snowballs,” retinal periphlebitis, preretinal inflammatory nodules, “candle wax drippings,” and choroidal lesions.[2,3]
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References 1. Khanna A, Sidhu U, Bajwa G, Malhotra V. Pattern of ocular manifestations in patients with sarcoidosis in developing countries. Acta Ophthalmol Scand 2007;85:609-12. 2. Smith JA, Foster CS. Sarcoidosis and its ocular manifestations. Int Ophthalmol Clin 1996;36:109-25. 3. Ghabrial R, McCluskey PJ, Wakefield D. Spectrum of sarcoidosis involving the eye and brain. Aust N Z J Ophthalmol 1997;25:221-4. Cite this article as: Suryaprakash V, Kanungo S, Biswas J. Peripheral choroidal nodules in a case of proven systemic sarcoidosis. Indian J Ophthalmol 2013;61:291-2. Source of Support: Nil. Conflict of Interest: None declared.
