A Case of Large Sarcoid Choroidal Granuloma Treated with Steroid Pulse Therapy

Takatoshi Kobayashi; Nanae Takai; Takaki Sato; Rei Tada; Eri Maruyama; Hiromi Shouda; Takako Okamoto; Kohichi Maruyama; Tsunehiko Ikeda

doi:10.1159/000506437

A Case of Large Sarcoid Choroidal Granuloma Treated with Steroid Pulse Therapy

Case Rep Ophthalmol. 2020 Mar 11;11(1):112-119. doi: 10.1159/000506437. eCollection 2020 Jan-Apr.

Authors

Takatoshi Kobayashi¹, Nanae Takai², Takaki Sato¹, Rei Tada³, Eri Maruyama¹, Hiromi Shouda¹, Takako Okamoto¹, Kohichi Maruyama⁴, Tsunehiko Ikeda¹

Affiliations

¹ Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.
² Takai Eye Clinic, Kawachinagano, Japan.
³ Tada Eye Clinic, Ikeda, Japan.
⁴ Maruyama Eye Clinic, Takatsuki, Japan.

Abstract

Purpose: To report a case of large sarcoid choroidal granuloma that was successfully treated with steroid pulse therapy.

Case report: A 38-year-old man presented with the primary complaint of decreased visual acuity (VA) in his left eye. Upon examination, a large white protruding lesion of 10 × 8 papilla diameter in size was observed in the macular region, and slightly temporal to it, in the patient's left eye. Whole-body contrast-enhanced computed tomography performed for differential diagnosis detected numerous enlarged lymph nodes throughout the body, including the bilateral hilar regions. Sarcoidosis was diagnosed by biopsy of the right cervical lymph nodes showing noncaseating epithelioid cell granuloma. The fundus lesion was found to be a choroidal granuloma caused by sarcoidosis, and steroid pulse therapy was started. The granuloma was considerably decreased, and the VA in the left eye improved to 0.7 after 2 months.

Conclusion: Steroid pulse therapy was found to be effective as an initial treatment for a large sarcoid choroidal granuloma.

Keywords: Choroidal granuloma; Sarcoidosis; Steroid pulse therapy.

Publication types

Case Reports