Grand Rounds
A patient with no past ocular history presented with right eye blurry vision for the past 4 months secondary to non-clearing vitreous hemorrhage. The exam was notable for visual acuity hand motion in the right eye and 20/20 in the left eye. Intra-ocular pressure was 17 and 17 mmHg in each eye. The slit-lamp exam was unremarkable with a clear cornea, no inflammatory cells or flare. There were no iris nodules/synechiae. Posterior segment exam with vitreous hemorrhage in the right eye and temporal area of nonperfusion. The left eye exam with temporal nonperfusion, focal area of heme with some fibrosis. Pt received an intravitreal injection of Bevacizumab followed by laser retinopexy to the avascular retina. The patient soon was undergone splenectomy. Pathology revealed non-caseating granulomas. The chest CT showed multiple lung nodules and hilar lymphadenopathy, then she started on systemic therapy. This case demonstrates an unusual presentation of ocular sarcoidosis manifesting as neovascularization and retinal vascular ischemia. The patient is currently doing well on systemic treatment and her vision improved to 20/30 in the right eye and remains good 20/25 in the left eye.
Presentation Date: 02/24/2022
Issue Date: 03/11/2022
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