Conjunctival Biopsy in Sarcoidosis

Scleritis associated with sarcoidosis

“…Bilateral conjunctival biopsies and the examination of multiple sections of each biopsy were essential to obtain this high of a yield. In a prospective study by Karcioglu et al, 16 the incidences of positive granulomatous lesions in proven and suspected sarcoidosis cases were 71.4% (10 of 14 patients) and 28.5% (4 of 14 patients), respectively. Thus, these authors recommended random, bilateral conjunctival biopsies in all cases of presumed sarcoidosis.…”

Non-Invasive Detection of Multinucleated Giant Cells in the Conjunctiva of Patients with Sarcoidosis by In-Vivo Confocal Microscopy

“…5 Karcioglu and Brear reported positive conjunctival biopsies in 71% of patients with biopsy-proven sarcoidosis and they found a 29% positive biopsy rate in patients with suspected sarcoidosis. 6 The detection of MGCs in these biopsies is not specifically addressed. Granulomatous inflammation may have varying etiologies, therefore finding granulomatous inflammation in the conjunctiva must be interpreted in the context of other clinical findings.…”

“…Although all patients in our study had uveal disease secondary to sarcoidosis, biopsy studies have not suggested that conjunctival sarcoidosis is more likely in the context of uveitis. 5,6 The detection of granulomatous inflammation in the conjunctiva is not specific for sarcoidosis and neither is the detection of MGCs specific for granulomatous inflammation. IVCM, in its present form, may be a useful addition to conventional means of diagnosing sarcoidosis.…”

Immunopathology of ocular sarcoidosis

“…2a); at this stage the lesion is not usually visible on slit-lamp examination, in that it does not modify the profile of the mucosa, and cannot be differentiated from conjunctival lymphoid aggregates by routine histological procedures. The expansion of this early macrophagic aggregate is accompanied by its migration to the inner substantia propria, and by an enrichment of the cellular mantle; when the diameter of the granuloma is larger than 0:25 mm it can affect the overlying epithelium in terms of contour and histologic appearance, becoming clinically detectable [10] (Fig. 2b).…”

“…With regard to ocular sarcoidosis, granulomatous lesions can affect the entire visual apparatus and its adnexa: the conjunctiva, lacrimal gland and uveal tract are most frequently involved [5,6]. Histological support for the diagnosis of sarcoidosis has often been provided by conjunctival tissue: the biopsy procedure is easy to perform and less invasive than lymph node or open lung biopsy, and the yield of non-caseating epithelioid cells granuloma varies from 17 to 71% according to the patient's race and the biopsy criteria (blind or purposeful biopsy), specimen size and accuracy of histological examination [5,[7][8][9][10].…”