Submacular Choroidal Granuloma from Sarcoidosis: A Case Report

Introduction: This article reports two cases of submacular choroidal granuloma from sarcoidosis, highlighting the critical importance of timely diagnosis and treatment for both visual and systemic prognosis. Case studies: Case 1 is a 60-year-old man who presented with blurred vision from a submacular choroidal granuloma. Initially, the lesion responded to oral prednisone, however, there was progression once the prednisone was stopped. One year later, he developed complete heart block and was diagnosed with cardiac sarcoidosis. He underwent pacemaker implantation and has been maintained on mycophenolate. Case 2 is a 35-year-old man who presented with distortion from a submacular choroidal granuloma that similarly responded to oral prednisone but progressed after it was discontinued. He had a chest computerized tomography scan and a subsequent lymph node biopsy that confirmed the diagnosis of sarcoidosis. He has remained stable and healthy, with 20/20 vision on methotrexate. Conclusion: Submacular choroidal granuloma from sarcoidosis is a rare condition that can cause vision loss if not treated promptly. These lesions usually respond to local or systemic corticosteroids. Diagnosis of these lesions is critical not only for visual preservation but also to prevent systemic complications.