Confluent choroidal infiltrates with sarcoidosis.
OBJECTIVE
To report the occurrence of confluent plaquelike choroidal infiltrates in four patients with sarcoidosis.


METHODS
The medical records of patients with choroidal plaquelike infiltrates and presumed systemic sarcoidosis seen in the Mayo Clinic were reviewed.


RESULTS
The cohort included four patients with confluent plaquelike choroidal infiltrates and systemic sarcoidosis. The most common ophthalmic symptom experienced by the patients was mild blurring of vision. The salient ophthalmic findings were choroidal infiltrates generally unaccompanied by other features frequently seen with sarcoidosis such as periphlebitis, multiple small yellowish choroidal infiltrations, vitreous cellular reaction, and granulomatous anterior uveitis. The choroidal lesions were confluent, yellowish, irregularly thickened infiltrates that frequently radiated peripherally from a peripapillary location in an ameboidlike pattern. Fluorescein angiography demonstrated early hypofluorescence and progressive patchy hyperfluorescence with late staining of the active lesions. Treatment with either systemic or subconjunctival steroids was associated with improvement in vision and partial resolution of the choroidal lesions. In two patients some of the lesions resolved spontaneously and became replaced by areas of chorioretinal atrophy.


CONCLUSIONS
Plaquelike yellowish choroidal infiltrates associated with systemic sarcoidosis may occur in eyes remarkably free of other signs of inflammation. The infiltrates tend to radiate from the region of the optic nerve in a confluent ameboidlike pattern. They generally respond to corticosteroids and may be the first recognized manifestation of systemic sarcoidosis.
Cook
B E
BE
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Robertson
D M
DM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D015862:Choroid Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015331:Cohort Studies; D003228:Conjunctiva / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000305:Adrenal Cortex Hormones