Choroidal white lesions as an early manifestation of sarcoidosis.
OBJECTIVE
To describe the natural history of a series of patients with fine white choroidal lesions and uveitis of previously unknown cause.


METHODS
A retrospective chart review of 11 patients with chronic uveitis and multiple, small (50-100 microm), peripheral white lesions of the choroid was performed using a standardized questionnaire form.


RESULTS
Ten of 11 patients were white women with an average age of 62 years. Seven of 11 patients had panuveitis; 4 of 11 patients had vitritis; and 6 of 11 patients had cystoid macular edema. Choroidal white lesions were bilateral in all but one patient. Seven of 11 patients were followed up for more than 1 year. During a 12- to 173-month follow-up (mean, 94 months), these patients showed coalescence and atrophy of the white lesions. Initial systemic examination for the cause of the uveitis and white choroidal lesions was negative in all seven patients. With long-term follow-up, sarcoidosis was diagnosed in five of the seven patients followed for more than 1 year.


CONCLUSIONS
The pattern of inflammatory white choroidal lesions distributed in the peripheral retina that atrophy and coalesce with time and that are associated with uveitis in middle-aged white women may represent an early form of sarcoidosis.
Thorne
J E
JE
Scheie Eye Institute, The Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Brucker
A J
AJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D015862:Choroid Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011795:Surveys and Questionnaires; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014792:Visual Acuity
D000305:Adrenal Cortex Hormones