a patient with decreased vision underwent complete ophthalmologic examination , ultrasound biomicroscopy , fluorescein and indocyanine green ( icg ) angiography .
the patient presented a nodule of the iris of the os and of the optic nerves of both eyes .
fluorescein and icg angiography are the only objective exams to demonstrate the extent of ocular involvement in a patient with sarcoidosis .
a 19-year - old black man noticed decreased vision in his os for approximately 2 months . at presentation
best - corrected visual acuity measured with a standard snellen chart was 0.8 os and 1.0 od .
slit - lamp examination revealed the presence of a granulomatous nodule of the iris of the os ( figure 1a ) , also detected by ultrasound biomicroscopy ( ubm ) ( figure 1b ) .
fundus examination showed a voluminous granuloma of the optic nerve of os ( figure 2 ) and a granulomatous lesion of the od , more visible on fluorescein angiography ( figure 3a , b ) , which shows optic disc leakage of os and hyperfluorescence of od .
multifocal choroidal lesions located in the posterior pole of the os only visible with indocyanine green ( icg ) were demonstrated ( figure 3c , d ) .
systemic medical and laboratory work - up was performed in order to diagnose the granulomatous disease .
chest computed tomography showed hilar adenopathy . a tissue biopsy obtained from the nose proved the presence of noncaseating granuloma .
sarcoidosis is a chronic multisystemic granulomatous disorder thought to result from an exaggerated cellular immune response to a variety of self antigens or nonself antigens ( newman et al 1997 ) .
the disease affects predominantly the lungs and thoracic lymph nodes , skin and eyes ( margolis 2007 ; chan et al 2007 ) . in this case report
however , only the icg angiography was capable of demonstrating the widespread extent of choroidal involvement .
 purposeto report a case with anterior and posterior nodules associated with systemic sarcoidosis.methodsa patient with decreased vision underwent complete ophthalmologic examination , ultrasound biomicroscopy , fluorescein and indocyanine green ( icg ) angiography.resultsthe patient presented a nodule of the iris of the os and of the optic nerves of both eyes . 
 chest computed tomography and tissue biopsy established the diagnosis.conclusionsfluorescein and icg angiography are the only objective exams to demonstrate the extent of ocular involvement in a patient with sarcoidosis . 
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Case report