Necrotising retinopathy-like lesions as a manifestation of ocular sarcoidosis

BACKGROUND: A 56-year-old Caucasian man presented with a 2-weeks history of decreased vision in the right eye. Vitritis, papillitis, cystoid macular oedema and inferior diffuse retinal infiltration were noticed. Extensive blood work-up, anterior chamber paracentesis with polymerase chain reaction (PCR) and Goldmann-Witmer coefficient, tuberculin skin test (PPD-test), fluorodeoxyglucose Positron Emission Tomography CT scan (FDG-PET/CT), lymph node biopsy and pars plana vitrectomy were performed. RESULTS: Aqueous and vitreous samples were negative for an infectious and a lymphoproliferative etiology. Enlarged hilar and mediastinal lymph nodes were detected by FDG-PET/CT and subsequently biopsied, allowing to confirm the diagnosis of sarcoidosis. After a few months of oral corticosteroid therapy, the inflammation resolved completely and was replaced by atrophic retinal scars. CONCLUSION: Necrotising retinopathy-like lesions mimicking an infectious process or a lymphoproliferative disorder can be an atypical manifestation of ocular sarcoidosis.