Two cases of ocular sarcoidosis in which vitreous cytology was useful for supporting diagnosis

Abstract

Abstract Purpose To report two cases of uveitis who are lacking the systemic signs were confirmed to be ocular sarcoidosis by vitreous cytology. Methods Case 1 was a 56‐year‐old man who was referred with blurred vision, and was found to have iridocyclitis, vitreous opacities, and papilledema bilaterally. He received pulsed corticosteroid therapy, however, the vitreous opacities and papilledema were not resolved. The second case was a 77‐year‐old man referred with blurred vision, and both eyes had snowball‐like vitreous opacities and optic nerve papilledema. The ocular findings in both cases strongly suggested sarcoidosis, however the systemic findings did not meet the diagnostic criteria of sarcoidosis. We performed pars plana vitrectomy (PPV) to remove the vitreous opacities, and collected all of the diluted vitreous during PPV and submitted for cytological analyses. Results Epithelioid cells and multinucleated giant cells, cells pathognomonic of sarcoidosis, were found in the vitreous samples which allowed us to make a diagnosis of sarcoidosis. Conclusion Vitreous cytology can help in making a diagnosis of ocular sarcoidosis especially in cases of ocular inflammations suggesting sarcoidosis but systemic findings that do not satisfy the diagnostic criteria.