Fong K F, Israel C W
South Med J. 1979 Feb;72(2):124-6. doi: 10.1097/00007611-197902000-00005.
The diagnosis of sarcoidosis with ocular involvement is often difficult and accompanied by a certain measure of uncertainty due to a paucity of additional physical signs. In the ophthalmic literature, it is controversial as to whether biopsy of a clinically normal conjuctiva should be done if sarcoidosis is suspected. Many authors advocate biopsy only in the presence of conjunctival follicles or nodules. However, a positive biopsy from a clinically normal-appearing conjunctiva has been reported. Recently, we saw a patient with bilateral uveitis, evanescent cranial nerve palsies, and other clinical manifestations suggesting central nervous system and ocular sarcoidosis. Random biopsy of a normal-appearing conjunctiva revealed a noncaseating granuloma consistent with sarcoidosis. Since conjunctival biopsy is a simple office procedure with minimal morbidity, this diagnostic tool should be considered for patients with clinically suspected sarcoidosis, even in the absence of conjunctival follicles or nodules.
结节病累及眼部时，诊断往往困难，且因缺乏其他体征而存在一定程度的不确定性。在眼科文献中，对于疑似结节病的患者是否应对外观正常的结膜进行活检存在争议。许多作者主张仅在存在结膜滤泡或结节时进行活检。然而，已有报道称外观正常的结膜活检呈阳性。最近，我们接诊了一名双侧葡萄膜炎、短暂性颅神经麻痹及其他提示中枢神经系统和眼部结节病临床表现的患者。对外观正常的结膜进行随机活检发现了与结节病相符的非干酪样肉芽肿。由于结膜活检是一种简单的门诊操作，并发症极少，对于临床疑似结节病的患者，即使没有结膜滤泡或结节，也应考虑使用这种诊断工具。
