Multiple arterial ectasias in patients with sarcoidosis and uveitis.
OBJECTIVE
To describe and evaluate the cause of a clinical entity characterized by bilateral intraocular inflammation, multiple arterial ectasias including beading, macroaneurysms, comma-like ectasias and kinking, with vasculitis, staining of the optic disk and multiple peripheral round punched-out hypopigmented chorioretinal scars in elderly patients. The formation and the course of the arterial ectasias is analyzed.


METHODS
Seven patients with this syndrome were evaluated by clinical examination, fluorescein angiography, and systemic investigations.


RESULTS
Three of the seven patients had a biopsy characteristic of sarcoidosis, two others showed positive bronchoalveolar lavage, as well as other analyses and tests suggesting sarcoidosis, and two showed other findings suggestive of sarcoidosis. The patients were all over 60 years of age and had arterial hypertension. In two patients, an arterial ectasia developed at the site of previous focal inflammation. The macroaneurysms either remained unchanged, became comma-like ectasias, arterial kinks, or completely vanished.


CONCLUSIONS
Elderly patients with multiple arterial ectasias, uveitis, disk staining, and peripheral chorioretinitis should be thoroughly investigated for sarcoidosis. We suggest that sarcoidosis may cause some degree of arteritis, which may weaken the arterial wall, with resulting ectasia. Arterial hypertension may play a role in the formation of the ectasias by increasing the pressure on the arterial wall weakened by inflammation.
Verougstraete
C
C
Centre Hospitaliers Universitaire Brugmann, Ophthalmologie, 4 Place A. Van Gehuchten, 1020 Brussels, Belgium.
Snyers
B
B
Leys
A
A
Caspers-Velu
L E
LE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D012161:Retinal Artery / Q000187:drug effects / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014792:Visual Acuity
D005938:Glucocorticoids; D008775:Methylprednisolone