Sarcoidosis with optic nerve and retinal involvement

J. D. Gass and C. L. Olson

A patient with the typical funduscopic changes of sarcoidosis died following an accident. The histopathological findings in one eye were correlated with the ophthalmoscopic observations made several days prior to death. Gross and histopathological examination revealed that the characteristic whitish-yellow focal retinal exudates, the perivascular exudates with an appearance like candle wax drippings, the preretinal and intravitreal nodules, and the localized tumefactions on the inner surface of the retina and optic nerve head noted ophthalmoscopically were a result of the nodular proliferation of epithelioid cells. These cells appeared to be derived primarily from blood vessels in the retina and optic nerve head. Although subpigment epithelial granulomas were found, there were no granulomas present within the choroid or elsewhere within the uvea.