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      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A Case of Large Sarcoid Choroidal Granuloma Treated with Steroid Pulse Therapy

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          Abstract

          Purpose: To report a case of large sarcoid choroidal granuloma that was successfully treated with steroid pulse therapy. Case Report: A 38-year-old man presented with the primary complaint of decreased visual acuity (VA) in his left eye. Upon examination, a large white protruding lesion of 10 × 8 papilla diameter in size was observed in the macular region, and slightly temporal to it, in the patient’s left eye. Whole-body contrast-enhanced computed tomography performed for differential diagnosis detected numerous enlarged lymph nodes throughout the body, including the bilateral hilar regions. Sarcoidosis was diagnosed by biopsy of the right cervical lymph nodes showing noncaseating epithelioid cell granuloma. The fundus lesion was found to be a choroidal granuloma caused by sarcoidosis, and steroid pulse therapy was started. The granuloma was considerably decreased, and the VA in the left eye improved to 0.7 after 2 months. Conclusion: Steroid pulse therapy was found to be effective as an initial treatment for a large sarcoid choroidal granuloma.

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          Most cited references25

          • Record: found
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          Sarcoidosis and its ophthalmic manifestations.

          Gordon Klintworth, Megan H. Shaw, C F Sydnor … (1978)
          Of 532 cases of sarcoidosis in the southeastern United States, ocular manifestations were a prominent feature of the disease in 202 (38%) of the patients. Approximately one fifth of them sought medical attention because of ocular complaints. This was the second most frequent clinical manifestation, exceeded only by pulmonary symptoms. When ocular segment structures were affected, the anterior segment was involved in 171 (84.7%) of cases. Chronic granulomatous uveitis was the most common abnormality in 106 cases (52.5%). Posterior segment disease occurred in 51 (25.3%) of cases, usually in the form of chorioretinitis or preiphlebitis; it was sometimes the sole manifestation of ocular sarcoidosis, but usually accompanied abnormalities in the anterior part of the eye. The incidence of central nervous system sarcoidosis was increased when posterior segment involvement was observed. Orbital and adnexal structures, primarily lacrimal gland, were affected in 53 (27.7%) of cases.
          Article 0 comments Cited 46 times – based on 0 reviews     Review now
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            Choroidal granulomas visualized by enhanced depth imaging optical coherence tomography.

            Alessandro Invernizzi, Chiara Mapelli, Francesco Viola … (2015)
            To assess the visualization of choroidal granulomas (CG) by enhanced depth imaging optical coherence tomography (EDI-OCT) and to describe their EDI-OCT characteristics.
            Article 0 comments Cited 24 times – based on 0 reviews     Review now
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              Sarcoidosis related uveitis: Clinical presentations, disease course and rates of systemic disease progression after uveitis diagnosis

              Shirley Ma, Sophie L. Rogers, Anthony Hall … (2018)
              To document the clinical presentation, treatment, and visual outcome of sarcoid uveitis and to determine the timing and potential risk factors of sarcoidosis progression to symptomatic systemic disease from the time of sarcoid uveitis diagnosis.
              Article 0 comments Cited 16 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): COP
                Journal ID (pmc): COP
                Journal ID (doi): 10.1159/issn.1663-2699
                Title: Case Reports in Ophthalmology
                Publisher: S. Karger AG
                ISSN (Electronic): 1663-2699
                Publication date Subscription-year: 2020
                Publication date Collection: January – April 2020
                Publication date (Electronic): 11 March 2020
                Volume: 11
                Issue: 1
                Pages: 112-119
                Affiliations
                [_a] aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
                [_b] bTakai Eye Clinic, Kawachinagano, Japan
                [_c] cTada Eye Clinic, Ikeda, Japan
                [_d] dMaruyama Eye Clinic, Takatsuki, Japan
                Author notes
                *Prof. Tsunehiko Ikeda, MD, PhD, Department of Ophthalmology, Osaka Medical College, 2–7 Daigaku-machi, Takatsuki, Osaka 569-8686 (Japan), tikeda@osaka-med.ac.jp
                Article
                Publisher ID: 506437 Other ID: Case Rep Ophthalmol 2020;11:112–119
                DOI: 10.1159/000506437
                SO-VID: 6069a415-f271-483a-966d-99574fa94d68
                Copyright © © 2020 The Author(s). Published by S. Karger AG, Basel
                License:

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 04 October 2019
                Date accepted : 11 February 2020
                Page count
                Figures: 6, Pages: 8
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Choroidal granuloma,Sarcoidosis,Steroid pulse therapy
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Choroidal granuloma, Sarcoidosis, Steroid pulse therapy

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