Illustration of an eye with inflamed blood vessels and granulomas, symbolizing necrotizing retinopathy in sarcoidosis.

Sarcoidosis and Sight: Understanding Necrotizing Retinopathy

Mira Elwood in Health & Wellness July 2025 • 4 min read.

"A rare case highlights the link between sarcoidosis and a vision-threatening eye condition, emphasizing the importance of early detection and treatment."

Sarcoidosis, also known as Besnier-Boeck disease, is a condition where the immune system goes awry, leading to the formation of granulomas (clumps of inflammatory cells) in various organs. While it commonly affects the lungs and lymph nodes, it can impact any part of the body, including the eyes. Sometimes, eye problems are the first sign that someone has sarcoidosis.

This article explores a rare instance of sarcoidosis affecting the eyes, specifically a case of necrotizing retinopathy. This is where the retina, the light-sensitive tissue at the back of the eye, suffers damage and cell death. What makes this case particularly noteworthy is that it mimicked acute retinal necrosis (ARN), a similar condition usually caused by viral infections, and resulted in a retinal detachment.

We will delve into the details of a 38-year-old man's experience with this condition, from initial symptoms and diagnosis to treatment and outcomes. This case underscores the importance of recognizing the diverse ways sarcoidosis can manifest and the need for prompt intervention to preserve vision.

What is Necrotizing Retinopathy and How Does Sarcoidosis Play a Role?

Illustration of an eye with inflamed blood vessels and granulomas, symbolizing necrotizing retinopathy in sarcoidosis.

Necrotizing retinopathy is a severe eye condition characterized by inflammation and death of retinal tissue. While often linked to viral infections like herpes simplex or varicella-zoster, it can sometimes arise from non-infectious causes. Sarcoidosis is one such cause, although it's a rare presentation.

In sarcoidosis, the inflammation can affect the blood vessels supplying the retina, leading to a lack of oxygen and nutrients. This can result in tissue damage, necrosis (cell death), and the formation of retinal infiltrates (inflammatory deposits). In some cases, this process can lead to retinal detachment, where the retina pulls away from the back of the eye.

Symptoms: Patients may experience blurred vision, floaters, pain, and redness in the eye.
Diagnosis: Diagnosis involves a thorough eye exam, including slit-lamp examination and fundus evaluation (examining the back of the eye). Blood tests and imaging studies (like gallium scans) may be needed to confirm sarcoidosis.
Treatment: Treatment typically involves corticosteroids to reduce inflammation. In some cases, antiviral medications may be used initially to rule out viral causes. Surgery may be necessary to repair retinal detachment.

The case report highlights a 38-year-old man who initially presented with symptoms mimicking acute retinal necrosis. He had panuveitis (inflammation of the entire eye), occlusive periarteritis (inflammation of the arteries in the retina), and inflammatory infiltrates in the peripheral retina. After a thorough investigation, he was diagnosed with asymptomatic systemic sarcoidosis.

Protecting Your Vision: Key Takeaways and the Importance of Early Intervention

This case underscores the importance of considering sarcoidosis in the differential diagnosis of necrotizing retinopathy, even when viral causes are suspected. Early diagnosis and treatment are crucial to minimize vision loss and prevent complications like retinal detachment.

If you experience any sudden changes in vision, eye pain, or redness, it's essential to seek prompt medical attention from an ophthalmologist. If you have been diagnosed with sarcoidosis, regular eye exams are crucial to monitor for any signs of ocular involvement.

While necrotizing retinopathy secondary to sarcoidosis is rare, this case serves as a reminder of the diverse ways systemic diseases can affect the eyes. By staying informed and proactive, you can protect your vision and overall health.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1177/112067211002000131, Alternate LINK

Title: Necrotizing Retinopathy Simulating Acute Retinal Necrosis Causing Rhegmatogenous Retinal Detachment In Sarcoidosis: A Case Report

Subject: Ophthalmology

Journal: European Journal of Ophthalmology

Publisher: SAGE Publications

Authors: Radha Shenoy, Badar Ai Burwani

Published: 2010-01-01

Everything You Need To Know

What is necrotizing retinopathy, and how does sarcoidosis cause it?

Necrotizing retinopathy is a serious condition where the retina experiences inflammation and cell death. Sarcoidosis can contribute to this when inflammation affects the retinal blood vessels, depriving the retina of oxygen and nutrients. This can lead to tissue damage, retinal infiltrates, and potentially retinal detachment. While viral infections are common causes of necrotizing retinopathy, sarcoidosis represents a less frequent, non-infectious origin. The presence of granulomas can obstruct blood flow. Unlike the typical viral causes, sarcoidosis-related necrotizing retinopathy requires a different treatment approach focused on managing the underlying immune response.

Can you tell me more about the specific case of necrotizing retinopathy linked to sarcoidosis?

The case described involved a 38-year-old man who initially showed symptoms resembling acute retinal necrosis (ARN). He had panuveitis, occlusive periarteritis, and inflammatory infiltrates in his peripheral retina. Further investigation revealed that he had asymptomatic systemic sarcoidosis. The case is significant because it highlights how sarcoidosis can mimic other conditions, like ARN, making accurate diagnosis challenging but crucial for effective treatment and vision preservation. This case emphasizes the need to consider sarcoidosis even when initial symptoms point to more common causes.

What are the warning signs of necrotizing retinopathy when it's connected to sarcoidosis?

Symptoms of necrotizing retinopathy related to sarcoidosis can include blurred vision, floaters, eye pain, and redness. Diagnosis usually involves a comprehensive eye examination using tools like a slit-lamp and fundus evaluation to examine the back of the eye. Additional tests, such as blood tests and imaging like gallium scans, might be necessary to confirm a diagnosis of sarcoidosis. Early detection of these symptoms can improve the chances of successful treatment and reduce the risk of vision loss. Monitoring for eye-related symptoms is important for individuals diagnosed with sarcoidosis.

What are the treatment options for necrotizing retinopathy caused by sarcoidosis?

The primary treatment for necrotizing retinopathy caused by sarcoidosis involves corticosteroids to reduce inflammation. Antiviral medications might initially be used to rule out viral causes, especially if acute retinal necrosis (ARN) is suspected. If retinal detachment occurs, surgery may be necessary to repair it. Managing sarcoidosis-related eye issues requires a comprehensive approach aimed at controlling inflammation, preventing further damage, and addressing any complications that arise.

Why is it so important to catch and treat sarcoidosis-related eye issues early?

Early intervention is critical to protect your vision when sarcoidosis affects the eyes. Because sarcoidosis can manifest in various ways and mimic other conditions like acute retinal necrosis (ARN), prompt and accurate diagnosis is essential. This requires a thorough eye examination and possibly systemic evaluation for sarcoidosis. Early treatment with corticosteroids and, if necessary, surgery for complications like retinal detachment can minimize vision loss and prevent further damage. Regular eye exams are important, especially for individuals diagnosed with sarcoidosis.