Immunohistochemical study of epiretinal proliferative cellular tissue from a patient with sarcoidosis.

BACKGROUND Sarcoidosis is a granulomatous disease causing uveitis. Although steroid therapy is usually effective for many patients, some are resistant to this therapy. In such cases, vitrectomy may be chosen as the therapeutic method to treat intraocular inflammation. CASE A 26-year-old Japanese man was diagnosed as having sarcoidosis by clinical findings and histological examination of bronchoalveolar lavage. OBSERVATION One year after diagnosis, vitreous opacity worsened and pars plana vitrectomy (PPV) was performed. Six months later, recurrence of vitreous opacity appeared and severe retinal exudative changes with proliferative vitreoretinopathy developed. One year after the first operation, PPV was repeated and the epiretinal proliferative tissue was removed and examined. CONCLUSIONS Histologic examination of the specimen showed scattered noncaseating granulomatous inflammation mainly consisting of epithelioid histiocytes and lymphocytes. Plasma cells as well as T cells were identified and the predominance of CD8-positive T cells was demonstrated. Taking everything into consideration, a new finding of CD8 predominance in the epiretinal proliferative tissue was demonstrated.