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. 2023 Dec 20;40(4):e2023039.
doi: 10.36141/svdld.v40i4.15122.

Choroidal Nodules in Ocular Sarcoidosis

Stéphane Abramowicz  1 , Michel Wassef  2 , Sara Touhami  3
Affiliations

Choroidal Nodules in Ocular Sarcoidosis

Stéphane Abramowicz et al. Sarcoidosis Vasc Diffuse Lung Dis. .

Abstract

Background and aim: Ocular sarcoidosis is present in 30-60% of all sarcoidosis patients. Our purpose is to increase awareness of the various presentations of ocular sarcoidosis.

Methods: Short image-based clinical case report.

Results: We report on a case of ocular sarcoidosis presenting with unilateral choroidal nodules in a middle-aged man. Sarcoid uveitis is generally bilateral and rather symmetrical. However, choroidal nodules are an exception to this rule, as they generally arise unilaterally. Choroidal nodules are highly responsive to oral corticosteroids. When left untreated, they may evolve to chorioretinal atrophy and secondary choroidal neovascularization.

Conclusions: Knowledge of this presentation of ocular sarcoidosis can help clinicians optimize treatment outcomes for patients.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Multimodal imaging of choroidal nodules in the left eye, before and after steroid treatment. A-C: Imaging before treatment. A) Fundus photograph showing scattered, round, yellowish spots at the level of the choroid, mostly visible in the nasal periphery (arrow). B) Ultra-wide field (UWF) fluorescein angiography (FA) showing papillitis and some faint hyperfluorescent spots in the nasal periphery (arrow). There is no retinal vasculitis. C) Intermediate-phase UWF indocyanine green angiography (ICGA) showing multiple hypofluorescent spots in the nasal periphery (arrow), and also some spots in the macular region (which were not visible on fundus examination). D-F: Imaging 6 months after treatment initiation. D) Fundus photograph showing reduction in choroidal spot size and number. Some hypopigmented choroidal spots can still be seen however. E) UWF FA showing hyperfluorescence (window defects) at the level of the hypopigmented choroidal spots, indicating some degree of chorioretinal atrophy. Some mild papillitis can still be seen on the superior aspect of the disc. F) Intermediate-phase 55° ICGA showing reduction in the number of spots in the macular area. UWF ICGA showed reduction in spot size and number, with some hypofluorescent spots remaining corresponding to choroidal scars (unfortunately quality too poor for publication).
See this image and copyright information in PMC

References

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