Fundus changes in histologically confirmed sarcoidosis.

We reviewed the clinical features, natural history and visual prognosis of 26 patients with histologically confirmed sarcoidosis. Compatible chest x-ray changes were found in 75% of patients. Periphlebitis was the commonest fundus feature. Disc changes were seen in a substantial number of patients, and the condition can present as unilateral disc oedema. The disease seems primarily to involve equatorial retinal veins, and occlusions of a hemisphere branch vein or central retinal vein did not occur. Changes in the subretinal pigment epithelium were noted in a substantial number of patients but did not produce visual morbidity, and these patients seemed to have less florid periphlebitis than others. The disease has a low visual morbidity unless neovascularisation develops; the treatment of this remains controversial.