Ocular sarcoidosis: A clinicopathological study

Abstract

Purpose: This study aims to deliver an in-depth analysis and detailed account of 15 patients diagnosed with ocular and periocular sarcoidosis, each case substantiated by biopsy and histopathological examination. Furthermore, our series emphasizes the critical role of computed tomography (CT) scans in assessing the lacrimal gland, particularly when clinical symptoms, paraclinical findings, and radiological evidence suggest the presence of sarcoidosis. Methodology: We conducted a retrospective analysis of biopsy-diagnosed sarcoidosis cases at the MUHC-McGill University Ocular Pathology and Translational Research Laboratory spanning from 1995 to 2023. Pathological descriptions were thoroughly assessed, and clinical information was obtained from medical records for each patient. Results: A total of 15 cases were analyzed, 8 females and 7 males, with ages ranging from 16 to 89. All biopsies revealed granulomatous inflammation characterized by discrete, noncaseating granulomas. The most common site for biopsy was the lacrimal gland, followed by conjunctiva. Patients who underwent lacrimal gland biopsy exhibited bilateral, symmetrical enlargement of the gland, as confirmed by a CT scan. Conclusion: Diagnosing sarcoidosis presents significant challenges. Conducting blind biopsies is inadvisable and should be avoided. Targeted biopsies of abnormal lesions in the conjunctiva and eyelid have been proven to be diagnostic. In cases of suspected sarcoidosis, a CT scan of the orbit serves as an invaluable tool for determining the optimal biopsy site, thereby enhancing diagnostic accuracy.