TY - JOUR
T1 - Non-caseating Conjunctival Granulomas in Patients with Multifocal Choroiditis and Panuveitis
AU - Hershey, Jonathan M.
AU - Pulido, Jose S.
AU - Folberg, Robert
AU - Folk, James C.
AU - Massicotte, Stephen J.
N1 - Funding Information:
Originally received: October 14, 1992. Revision accepted: September 3, 1993. 1 Department of Ophthalmology, The University of Iowa, Iowa City, Iowa. 2 Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin. 3 Department of Pathology, The University of Iowa, Iowa City, Iowa. Dr. Massicotte is currently with the Department of Ophthalmology, Indiana University; Dr. Hershey is currently with Retina and Vitreous Consultants of Wisconsin Ltd., Milwaukee, Wisconsin. Presented in part as a poster at the American Academy of Ophthalmology Annual Meeting, Anaheim, October 1991. Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, and a Margaret and W.A. Logan Research Award. Reprint requests to Jose S. Pulido, MD, The Eye Institute, Medical College of Wisconsin, 8700 W. Wisconsin Avenue, Milwaukee, WI 53226.
PY - 1994
Y1 - 1994
N2 - Conclusions: This study describes a group of patients with clinical findings of peripheral punched-out lesions and panuveitis who had non-caseating granulomas found by nondirected conjunctival biopsy. Methods: A series of 10 patients seen at The University of Iowa Hospitals and Clinics between August 1989 and August 1990 with ocular findings similar to those of multifocal choroiditis with panuveitis, including peripheral punched-out chorioretinal lesions, vitritis, and frequently, cystoid macular edema, was examined. All patients underwent ophthalmic examination, ancillary testing, and non-directed conjunctival biopsy. Results: Of the ten patients, nine were women. Results of FTA-ABS were negative for all patients. A non-directed conjunctival biopsy disclosed non-caseating granulomata in seven of the patients. Acid-fast bacilli were not detected in any specimens. Four of the seven patients with positive biopsy results had either elevated serum angiotensinconverting enzyme levels or chest x-rays consistent with sarcoid. Six of these seven patients were 58 years of age or older. Conclusion: It is recommended that non-directed conjunctival biopsy specimens be examined to exclude the presence of non-caseating granulomata in uveitis patients with small, inferior, peripheral, punched-out chorioretinal scars, especially in women older than 55 years of age.
AB - Conclusions: This study describes a group of patients with clinical findings of peripheral punched-out lesions and panuveitis who had non-caseating granulomas found by nondirected conjunctival biopsy. Methods: A series of 10 patients seen at The University of Iowa Hospitals and Clinics between August 1989 and August 1990 with ocular findings similar to those of multifocal choroiditis with panuveitis, including peripheral punched-out chorioretinal lesions, vitritis, and frequently, cystoid macular edema, was examined. All patients underwent ophthalmic examination, ancillary testing, and non-directed conjunctival biopsy. Results: Of the ten patients, nine were women. Results of FTA-ABS were negative for all patients. A non-directed conjunctival biopsy disclosed non-caseating granulomata in seven of the patients. Acid-fast bacilli were not detected in any specimens. Four of the seven patients with positive biopsy results had either elevated serum angiotensinconverting enzyme levels or chest x-rays consistent with sarcoid. Six of these seven patients were 58 years of age or older. Conclusion: It is recommended that non-directed conjunctival biopsy specimens be examined to exclude the presence of non-caseating granulomata in uveitis patients with small, inferior, peripheral, punched-out chorioretinal scars, especially in women older than 55 years of age.
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U2 - 10.1016/S0161-6420(94)31296-6
DO - 10.1016/S0161-6420(94)31296-6
M3 - Article
C2 - 8127581
AN - SCOPUS:0028325847
SN - 0161-6420
VL - 101
SP - 596
EP - 601
JO - Ophthalmology
JF - Ophthalmology
IS - 3
ER -