P 421
Choroidal granuloma of the disc in sarcoidosis clinical and angiographic findings
A. U. Luhr1, K. Hoffmann2
Introduction: the etiology of sarcoidosis is unknown, inflammation and virus diseases are discussed. Sarcoidosis can afflict almost every structure in the eye, it can vary from an isolated iridocyclitis to a bilateral panuveitis.Choroidal granuloma of the disc in ocular sarcoidosis is rare (5.8% Naumann et.al.) and can cause visual disturbances.
To demonstrate the clinical outcome of ocular sarcoidosis with granuloma of the disc fluorescein and ICG angiographic findings are shown.
Participants: 33 year old male patient complained a sudden loss of vision in the left eye, showing a mild iridocyclitis. Ophthalmoscopy presented a big grey white granuloma surrounding the disc, with serous detachment of the fovea. Toxoplasmosis and other inflammations were discussed. A positive laboratory testing of ACE and a prominent hilar adenopathy on the chest x-ray confirmed the clinical suspected diagnosis of sarcoidosis. Systemic corticosteroid therapy showed no improvement subsequently MTX treatment was started. Fluorescein and ICG angiography showed hyperfluorescence of the granuloma with staining in the late phase. Leakage was absent. Visual acuity and ophthalmoscopy is stable for 18 month now.
Conclusion: focal choroidal granuloma of the disc in ocular sarcoidosis is rare and can cause a rapid loss of vision if untreated. If corticosteroids failed low dose MTX is an effective adjunct to treat chronic sarcoidosis. Angiography helps to follow the clinical course.
1
Medizinische Hochschule Hannover, Augenklinik, Carl-Neuberg-Str. 1, D-30625 Hannover