Comparison of retinal and choroidal involvement in sarcoidosis-related chorioretinitis using fluorescein and indocyanine green angiography

To compare the involvement of the retina with that of the choroid in ocular sarcoidosis (OS) using dual fluorescein angiography (FA)/indocyanine green angiography (ICGA). A retrospective study of 23 patients with the diagnosis of OS was performed. Angiographic signs were quantified following the established FA/ICGA scoring system for uveitis. The choroid was predominantly involved in 19 (82.6%) patients or 87% (40/46) of the eyes, and the retina in 2 (8.7%) patients or 13% (6/46) of the eyes. The mean angiographic score was 7.15 ± 4.5 for the retina (FA) compared to 14.02 ± 4.86 for the choroid (ICGA) (P < 0.0001). In 13% (3/23) of patients, FA did not show retinal inflammation, whereas ICGA was strongly positive, revealing occult choroidal lesions. The choroid is preferentially involved in OS, for which ICGA is the examination of choice. There is a risk of underestimating the global ocular involvement and of missing choroidal involvement if only FA is used. FA/ICGA scoring system allows for quantitative assessment of inflammation in the posterior uvea that occurs in OS; therefore, the system can be useful to quantitatively monitor outcomes in clinical trials.