Arterial macroaneurysms in peripheral multifocal chorioretinitis associated with sarcoidosis.
OBJECTIVE
This study aimed to describe the clinical presentation, angiographic findings, and natural history of acquired arterial macroaneurysms diagnosed in 8 of 48 patients with peripheral multifocal chorioretinitis (PMC) (panuveitis with multiple peripheral punched-out chorioretinal lesions).


METHODS
A retrospective case-control study.


METHODS
Forty-eight consecutive patients with PMC, consisting of 13 patients with histologically or radiologically proven sarcoidosis, 11 with laboratory evidence of (presumed) sarcoidosis, and 24 with no evidence of systemic disease, participated in the study.


METHODS
A review of the clinical, photographic, and angiographic records was performed.


METHODS
Arterial macroaneurysms, clinical symptoms, and associations with systemic disease were measured.


RESULTS
Of 48 patients with PMC, 8 (17%) had arterial macroaneurysms: 3 (38%) of 8 with histologically proven sarcoidosis, 1 (20%) of 5 with radiologically proven sarcoidosis, 2 (18%) of 11 with laboratory evidence of sarcoidosis, and 2 (8%) of 24 patients with no evidence of systemic sarcoidosis. All eight patients were white females older than 60 years of age. Macroaneurysms appeared to be unrelated to the systemic hypertension (5 of 17 compared to 3 of 31; P = 0.11); however, the frequency of cerebrovascular accidents or myocardial infarctions was higher among those with macroaneurysms (5 of 8 vs. 2 of 40; P = 0.0000). Three of the eight patients reported visual complaints related to macroaneurysms; only one patient required laser treatment. Fluorescein angiography showed no evidence of previous vasculitis in the involved area.


CONCLUSIONS
Arterial macroaneurysms, which occur in elderly female patients with PMC, are associated with severe cardiovascular disease. Whether the macroaneurysms are a complication of an inflammatory vascular process remains speculative.
Department of Ophthalmology, FC Donders Institute, Academic Hospital Utrecht, The Netherlands.
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Rothova
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Lardenoye
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000150:complications; D016022:Case-Control Studies; D002825:Chorioretinitis / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000150:complications / Q000473:pathology; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery; D012170:Retinal Vein Occlusion / Q000209:etiology; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging