A 35-year-old patient with sarcoidosis presents with decreased vision. Fundus examination reveals periphlebitis with 'candle wax drippings' (perivenous exudates), disc edema, and anterior uveitis with large mutton-fat keratic precipitates. The pathological finding in sarcoid uveitis is best described as:
- A Caseating granulomas with Langhans giant cells
- B Suppurative granulomas with central necrosis
- C Non-caseating epithelioid cell granulomas with multinucleate giant cells ✓
- D Necrotising retinal vasculitis with fibrinoid deposition
Correct answer: C. Non-caseating epithelioid cell granulomas with multinucleate giant cells
Explanation
Sarcoidosis causes non-caseating epithelioid cell granulomas—collections of activated epithelioid macrophages and multinucleated giant cells (Langerhans and foreign body types) without central caseation, distinguishing sarcoid from tuberculosis (which causes caseating granulomas). Ocular sarcoidosis typically causes granulomatous panuveitis with large mutton-fat KPs, Koeppe/Busacca iris nodules, and the classic fundus finding of perivasculitis with 'candle wax dripping' exudates (taches de bougie). Serum ACE and chest CT/CXR support the diagnosis.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.