Sarcoid uveitis: A case report and systematic review of literature

Sarcoidosis is a disease characterized by non caseous necrotizing granuloma with multiple systems and organs. About 25%–80% of patients have ocular involvement. Here we present an extremely rare case of sarcoid uveitis. A 54-year-old woman with diabetes for 5 years presented with a 4-month dark flutter in her left eye. She first diagnosed as having left eye fungal endophthalmitis because of the vitritis and obvious haze. She underwent a pars plana vitrectomy surgery, after which intraocular fluid was send out for fungus detection. However, no fungus infection was found. Then the result of her chest CT scan draw our attention which revealed multiple enlarged lymph nodes in mediastinum. After endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy of enlarged hilar intrathoracic lymph nodes, her histological diagnosis was sarcoidosis. After topical and systemic steroids treatments, the visual acuity was improved. Eye involvement may be the first sign of sarcoidosis. Clinical differences such as string of pearl-type vitreous opacities are sometimes not enough for differential sarcoid uveitis and fungal endophthalmitis. The laboratory intraocular fluid analysis is one of the contributor to the final differential diagnosis.