Abstract
Purpose:To compare the involvement of the retina with that of the choroid in ocular sarcoidosis (OS) using dual fluorescein angiography (FA)/indocyanine green angiography (ICGA).Methods:A retrospective study of 23 patients with the diagnosis of OS was performed. Angiographic signs were quantified following the established FA/ICGA scoring system for uveitis.Results:The choroid was predominantly involved in 19 (82.6%) patients or 87% (40/46) of the eyes, and the retina in 2 (8.7%) patients or 13% (6/46) of the eyes. The mean angiographic score was 7.15 ± 4.5 for the retina (FA) compared to 14.02 ± 4.86 for the choroid (ICGA) (P < 0.0001). In 13% (3/23) of patients, FA did not show retinal inflammation, whereas ICGA was strongly positive, revealing occult choroidal lesions.Conclusion:The choroid is preferentially involved in OS, for which ICGA is the examination of choice. There is a risk of underestimating the global ocular involvement and of missing choroidal involvement if only FA is used. FA/ICGA scoring system allows for quantitative assessment of inflammation in the posterior uvea that occurs in OS; therefore, the system can be useful to quantitatively monitor outcomes in clinical trials.
Highlights
We performed an assessment of sarcoidosis‐related chorioretinitis using dual fluorescein angiography/indocyanine green angiography (FA/ICGA)
We showed that sarcoidosis‐related chorioretinitis involves both the retinal and the choroidal structures independently, and lesions in one compartment are not a consequence of the lesions in the other compartment
This indicates that, unlike in Vogt‐Koyanagi‐Harada disease – where the choroidal stroma is selectively and exclusively generating inflammation with lesions in the other structures being the consequence of a spill‐over of the choroidal inflammation[9,10] – any eye structure can be involved at random in ocular sarcoidosis; the ocular structures are innocent bystanders in which the systemic disease can produce lesions
Summary
Sarcoidosis is a chronic multisystem granulomatous disease characterized by the presence of non‐caseating. The commonly affected organs are the lungs, skin, and eyes. The frequency of ocular involvement ranges from 25% to 80%. Most patients present between the ages of 20 and 40 years; children and the elderly can be affected. Ocular involvement appears early in the course of the disease and may co‐exist with asymptomatic systemic disease or precede systemic involvement by several years. The criteria for the diagnosis of ocular sarcoidosis (OS) were described by the first International
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