On fundus examination of a patient with sarcoidosis-associated posterior uveitis, 'candle-wax drippings' are noted along the retinal veins. These lesions represent:

• A Sub-internal limiting membrane haemorrhages from venous occlusion
• B Segmental retinal arterial macroaneurysms leaking lipid
• C Perivenous granulomatous sheathing and exudation (sarcoid periphlebitis) ✓
• D Choroidal granulomas eroding through Bruch membrane into the vein wall

Explanation

Candle-wax drippings, or taches de bougie, are the classic fundus sign of sarcoid periphlebitis: granulomatous inflammation of the venous wall producing thick, lumpy, yellowish-white perivascular exudation resembling melted wax poured along the vessel. Venous involvement predominates in sarcoidosis, unlike Behcet disease where occlusive periphlebitis and branch retinal vein occlusions dominate. The lesions are within the venous wall and perivascular space, not choroidal granulomas breaking through Bruch membrane.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.