title: [Diagnostic evaluation of sarcoid choroidal granuloma using high-penetration optical coherence tomography].
abstract: OBJECTIVE
  We report a case of sarcoidosis that manifested as choroidal granuloma. We followed the treatment-associated changes in the granulomatous lesion by serial examinations using high-penetration optical coherence tomography (HP-OCT).
  
  
  METHODS
  A 77-year-old woman, who was referred to our clinic with granulomatous uveitis, presented initially with a yellowish-white subretinal granuloma formation surrounding the left optic disk. On presentation, diffuse keratic precipitates, anterior chamber inflammation and snowball-like vitreous opacity were observed. The HP-OCT image of subretinal lesion showed a low density choroidal space-occupying lesion. Due to the presence of bilateral hilar lymphadenopathy based on a close inspection of the entire body and abnormal cardiac/mediastinal uptake with positron emission tomography in combination with computed tomography (PET-CT), the definite clinical diagnosis group of sarcoidosis was made. Sub-Tenon injection of triamcinolone acetonide (STTA) was administered. In response to the treatment, HP-OCT showed that the choroidal granuloma had disappeared. Six months after treatment, the lesion recurred, however, this choroidal lesion resolved on OCT within the following 6 months in response to an STTA injection. As a complete atrioventricular block was observed during the follow-up, a pacemaker was implanted.
  
  
  CONCLUSIONS
  The findings and clinical course strongly suggested choroidal granuloma of ocular sarcoidosis. HP-OCT allowed a detailed observation of the space-occupying lesion and helped make a diagnosis and observe the course of treatment.
authors: Mayuri
authors: M
authors: Ohtsuka
authors: Noriyasu
authors: N
authors: Hashida
authors: Kenta
authors: K
authors: Hozumi
authors: Kohji
authors: K
authors: Nishida
mesh_terms: D000368:Aged; D002830:Choroid Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D041623:Tomography, Optical Coherence; D014057:Tomography, X-Ray Computed