Biopsy-proven ocular sarcoidosis manifesting as Weerfordt-Waldenström syndrome presenting with bilateral anterior granulomatous uveitis, multifocal retinal granulomas, and multifocal choroiditis

Sarcoidosis is a systemic granulomatous disease characterized by the formation of epithelioid and giant cell granulomas without caseous necrosis. Diagnosis relies on evidence of systemic granulomatous involvement affecting at least two organs, supported by clinical, laboratory, and histopathological findings. The most affected organs are the mediastinal lymphatic system, lungs, skin, and eyes. Ocular involvement in sarcoidosis occurs among 20 to 50% of patients, and commonly includes adnexal granulomatous infiltration and uveitis [1]. The latter typically manifests with anterior granulomatous uveitis, intermediate uveitis with snowballs, retinal vasculitis or peripheral multifocal choroiditis [1‐4]. Posterior segment granulomas are uncommon, and may involve the choroid, the optic nerve, or more rarely the retina [1, 5]. Diagnosis of ocular sarcoidosis is challenging, often made without the gold standard histological proof, based on clinical findings and laboratory results [5]. …