Intermediate Uveitis As The Sentinel Sign Of Pediatric Sarcoidosis
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT047 | Type: Case Report | DOI: 10.82333/td0x-qj44
Authors: Dr Rezki Wissem Hana* 1 , A/Prof. mouaki benani soraya 1
1medicine,chu Mustapha bacha,algiers,Algeria
Purpose
To describe a case of bilateral intermediate uveitis revealing systemic sarcoidosis in a pediatric patient and to emphasize the importance of comprehensive etiological assessment in childhood uveitis.
Setting
Department of Ophthalmology, University Hospital Center Mustapha, Algiers, Algeria.
Report of case
A 13-year-old girl presented with a one-week history of subacute bilateral visual impairment associated with floaters.A complete ophthalmologic examination,multimodal retinal imaging,laboratory investigations, and systemic evaluation were performe.Infectious and autoimmune causes were systematically excluded.
Result
Best-corrected visual acuity was 8/10 in both eyes. Slit-lamp examination showed no anterior segment inflammation.Fundus examination revealed bilateral vitritis with characteristic vitreous “snowballs” and peripheral retinal vasculitis.
Extensive infectious screening (toxoplasmosis, herpes viruses, syphilis,Lyme disease, tuberculosis) and immunologic testing (HLA-B27, ANA, ANCA, ASCA) were negative.Serum angiotensin-converting enzyme levels were elevated,Chest imaging demonstrated bilateral hilar lymphadenopathy.
Based on ocular findings, elevated ACE levels, radiologic evidence of hilar lymphadenopathy, and exclusion of alternative etiologies, presumed sarcoidosis-associated bilateral intermediate uveitis was diagnosed
Systemic corticosteroid therapy was initiated(intravenous methylprednisolone pulses followed by oral prednisone taper),combined with topical corticosteroids and cycloplegia. Visual acuity improved to 10/10 bilaterally within 15 days. No ocular complications were observed at one-month follow-up.
Conclusion/Take home message
Intermediate uveitis in children is uncommon and may represent the initial manifestation of systemic sarcoidosis. A structured diagnostic approach is essential to exclude infectious and autoimmune etiologies. Prompt systemic corticosteroid therapy ensures effective inflammatory control.Long-term monitoring is required to detect potential recurrences.