眼病変のみを臨床症状とするサルコイドーシス

Ocular sarcoidosis without extraocular clinical manifestations

　眼病変からサルコイドーシスを疑われ，他に本症に一致する臨床所見を認めなかった症例に経気管支肺生検を主とする生検を行った．11例中9例に肉芽腫性病変を示す組織像を得て，眼病変のみを臨床所見とするサルコイドーシスと診断した．

We performed detailed examination in 11 cases with ocular signs of sarcoidosis without apparent other clini-cal manifestations. We conducted, among others, trans-bronchial lung biopsy (TBLB) in 9 patiens, TBLB and superficial lymphnode biopsy in 1, and mediastinal lymphnode biopsy in 1.

There were at least two ocular signs from the follow-ing : iridocyclitis and/or iris nodules, trabecular nod-ules and/or tent-like peripheral anterior synechia, vitre-ous opacities in simulating snowballs or string of pearls, retinal perivasculitis, candlewax chorioretinal exudates, and nodular choroiditis.

The diagnosis of systemic sarcoidosis was given in 7 of the 9 patients who underwent TBLB and in 2 who underwent lymphnode biopsy, based on epithelioid granuloma without caseous necrosis. Our findings indicate that ocular involvement may be the sole clinical manifestation of systemic sarcoidosis, as biomicroscopic examinations are sensitive enough to detect minute changes of the disease.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40(11) : 1231-1235, 1986