American Academy of Ophthalmology Web Site: www.aao.org
Original URL:

June 2009

 
This Month's BLINK
Probable Sarcoid Panuveitis
Written by Ivan R. Schwab, MD, and George M. Watson, MD, Univer­sity of California at Davis Eye Center, Davis, Calif.
 
 

(PDF 180 KB)

June 2009 Blink


A 31-year-old African-American woman was referred for a one-year history of worsening vi­sion in both eyes associated with pressurelike pain and photophobia. Her corneas were notable for 4+ “mutton-fat” granulomatous keratic precipitates diffusely distributed in the right eye (see image) and 2+ similar findings in the left. Koeppe and Busacca iris nodules were also noted in both eyes. The vitreous contained 2+ active inflammatory cells in both eyes but periph­eral inflammatory snowballs were noted only in the right.

The patient had been diagnosed with optic neuritis 10 years prior and subsequent workup led to a diagnosis of multiple sclero­sis, which was controlled on Copaxone (glatiramer acetate). While bilateral granulomatous panuveitis has been associated with MS, we decided to proceed with a sarcoidosis workup. Initial lab data revealed a mildly elevated serum level of lysozyme (21 µg/ml), but angiotensin-converting enzyme levels were normal, and a CT scan of the chest did not reveal hilar adenopathy.
___________________________

BLINK SUBMISSIONS: Send us your ophthalmic image and its explanation in 150-250 words. E-mail to eyenet@aao.org, fax to 415- 561-8575 or mail to EyeNet Magazine, 655 Beach Street, San Francisco, CA 94109. Please note that EyeNet reserves the right to edit Blink submissions.

Top