Journal of Current Ophthalmology

CASE REPORT
Year
: 2021  |  Volume : 33  |  Issue : 2  |  Page : 205--208

Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab


Carl Stanley Wilkins1, Kristen Taylor Ashourian2, Ethan Kyle Sobol1, Matthew Fink3, Brian Saltzman4, Steven Teich4 
1 Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
2 Department of Ophthalmology, Stroger Eye Clinic/Cook County Health, Chicago, IL, USA
3 Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, USA
4 Icahn School of Medicine at Mount Sinai, New York, NY, USA

Correspondence Address:
Carl Stanley Wilkins
New York Eye and Ear Infirmary Retina Center, 310 East 14th Street, New York, NY
USA

Purpose: To report a rare paradoxical development of systemic sarcoidosis in a patient taking adalimumab manifesting as multifocal choroidal infiltrates and seventh nerve palsy. Methods: This was a single patient case report. Results: A 30-year-old man with a history of psoriatic arthritis on adalimumab presented with intermittent fevers and headaches. Initial infectious serology and initial ophthalmic examination were within normal limits. Over the next month, he developed a seventh nerve palsy, unilateral decreased visual acuity, and bilateral multifocal choroidal infiltrates. The patient was diagnosed with systemic sarcoidosis secondary to tumor necrosis factor alpha (TNFα) inhibitor use after a hilar lymph node biopsy. Upon treatment with high-dose oral corticosteroids, the patient's symptoms and choroidal lesions significantly improved. Conclusion: This case report illustrates a rare presentation of ocular, neurologic, and systemic sarcoidosis presenting as a bilateral multifocal choroiditis and seventh nerve paresis in a patient treated with adalimumab. We highlight the importance of obtaining an ophthalmic evaluation in the management of this rare adverse effect of TNFα inhibitors.


How to cite this article:
Wilkins CS, Ashourian KT, Sobol EK, Fink M, Saltzman B, Teich S. Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab.J Curr Ophthalmol 2021;33:205-208


How to cite this URL:
Wilkins CS, Ashourian KT, Sobol EK, Fink M, Saltzman B, Teich S. Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab. J Curr Ophthalmol [serial online] 2021 [cited 2021 Dec 1 ];33:205-208
Available from: http://www.jcurrophthalmol.org/article.asp?issn=2452-2325;year=2021;volume=33;issue=2;spage=205;epage=208;aulast=Wilkins;type=0