International Ophthalmology

, Volume 30, Issue 5, pp 603–606 | Cite as

Choroidal granuloma as an initial manifestation of systemic sarcoidosis

Case Report


Systemic sarcoidosis presenting as a choroidal nodule is a rare phenomenon, with limited reports in the past. We present a case of systemic sarcoidosis in a young adult male presenting as a solitary choroidal mass. The diagnosis was made based on elevated serum lysozyme, serum angiotensin-converting enzyme, negative Mantoux, and computed tomography (CT) scan of the chest. Ultrasound examination and fundus fluorescein angiography helped us to differentiate this lesion from choroidal melanoma. Magnetic resonance imaging (MRI) of brain was done to rule out neurosarcoidosis. Patient responded well to systemic steroid therapy, with marked resolution of the choroidal granuloma, and reduced size of mediastinal lymph nodes on repeat CT scan of the chest.


Amelanotic melanoma Choroidal granuloma Serum lysozyme Serum angiotensin Systemic sarcoidosis 


  1. 1.
    Letocha CE, Shields JA, Goldberg RE (1975) Retinal changes in sarcoidosis. Can J Ophthalmol 10:184–192PubMedGoogle Scholar
  2. 2.
    Ozazewski JC, Bennett V (1952) Ocular sarcoidosis. Report of three cases. Am J Ophthalmol 35:547–550PubMedGoogle Scholar
  3. 3.
    Olk RJ, Lipmann MJ, Cundiff HC, Daniels J (1983) Solitary choroidal mass as the presenting sign in systemic sarcoidosis. Br J Ophthalmol 6:826–829. doi: 10.1136/bjo.67.12.826 CrossRefGoogle Scholar
  4. 4.
    Tingey DP, Gonder JR (1992) Ocular sarcoidosis presenting as a solitary choroidal mass. Can J Ophthalmol 27:25–29PubMedGoogle Scholar
  5. 5.
    Stanbury RM, Graham EM, Murray PI (1995) Sarcoidosis. Int Ophthalmol Clin 35:123–137. doi: 10.1097/00004397-199503530-00010 CrossRefPubMedGoogle Scholar
  6. 6.
    Obenauf CD, Shaw HE, Sydnor CF, Klintworth GK (1978) Sarcoidosis and its ophthalmic manifestations. Am J Ophthalmol 86:648–655PubMedGoogle Scholar
  7. 7.
    Dufay-Dupar B, Soubrane G, Ortonne N (2006) Choroidal white dots and sarcoidosis. J Fr Ophtalmol 29:e23PubMedGoogle Scholar
  8. 8.
    Gould H, Kaufman HE (1961) Sarcoid of the fundus. Arch Ophthalmol 65:453–456PubMedGoogle Scholar
  9. 9.
    Kawaguchi T, Hanada A, Horie S, Sugamoto Y, Sugita S, Mochizuki M (2007) Evaluation of characteristic ocular signs and systemic investigations in ocular sarcoidosis patients. Jpn J Ophthalmol 51:121–126. doi: 10.1007/s10384-006-0413-2 CrossRefPubMedGoogle Scholar
  10. 10.
    Desai UR, Tawansy KA, Joondeph BC, Schiffman RM (2001) Choroidal granulomas in systemic sarcoidosis. Retina 21:40–47. doi: 10.1097/00006982-200102000-00007 CrossRefPubMedGoogle Scholar
  11. 11.
    Heck AW, Phillips LH II (1989) Sarcoidosis and the nervous system. Neurol Clin 7:641–654PubMedGoogle Scholar
  12. 12.
    Rouberol F, Duquesne N, Kodjikian L, Guerillon F, Grange JD (2002) Sarcoid granuloma simulating amelanotic melanoma of the iris: a case report. J Fr Ophtalmol 25:831–834PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  1. 1.Department of Ocular Pathology, Medical Research FoundationSankara NethralayaChennaiIndia

Personalised recommendations