Arterial macroaneurysms in peripheral multifocal chorioretinitis associated with sarcoidosis
Section snippets
Patients and methods
We reviewed the clinical and photographic records of 48 consecutive patients with PMC of the F.C. Donders Institute, University Hospital Utrecht, to assess the frequency and clinical features of an arterial macroaneurysm and to determine eventual risk factors contributing to its development.
All patients had chronic vitreitis with more than ten peripheral chorioretinal punched-out lesions. None of the patients had inflammatory chorioretinal lesions located within the large vascular arcades,
Results
The study included 8 male and 40 female patients with PMC. The average follow-up for PMC was 4.2 years; follow-up of the eight patients after the diagnosis of the macroaneurysm was at least 1 year (average, 2 years). The mean age at onset of PMC was 59 years.
Of 48 patients with PMC, 8 had arterial macroaneurysms (17%): 3 of 8 (38%) with histologic and 1 of 5 (20%) with radiologic confirmation of sarcoidosis, 2 of 11 (18%) with high angiotensin-converting enzyme levels and 2 of 24 (8%) who
Case 1
A 63-year-old woman with peripheral multifocal chorioretinitis and biopsy-proven sarcoidosis diagnosed at the age of 61 developed an arterial macroaneurysm of the inferior temporal artery in her best eye (Fig 1). Her ophthalmologic history included asymmetric sarcoid uveitis since the age of 61; she had mild chronic vitreitis in her right eye with peripheral punched-out lesions and a visual acuity of 20/20. However, she had severe panuveitis in her left eye with a peripheral choroidal granuloma
Discussion
In this study, arterial macroaneurysms were found in 8 (17%) of 48 patients with vitreitis and multiple punched-out lesions located in the periphery of the retina; 4 of these 8 had either histologically or radiologically proven sarcoidosis. In literature surveys, however, no other association of arterial macroaneurysm than that with cardiovascular diseases has been reported.2, 3, 4, 5, 6, 7, 8 The exact frequency of macroaneurysms in association with hypertension or other types of
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