Monique Munro

Sarcoidosis is a complex granulomatous systemic inflammatory disease that can affect the eye and its adnexa. Ocular sarcoidosis is a leading cause of inflammatory eye disease that can result in significant visual impairment. Ocular inflammation can manifest with a wide range of clinical presentations and can involve almost any structure within or around the orbit causing uveitis, episcleritis/scleritis, eyelid anomalies, conjunctival granulomas, optic neuropathy, lacrimal gland enlargement, glaucoma, and/or cataract. The diagnosis of ocular sarcoidosis is typically established based on the presence of characteristic ophthalmologic findings, along with a positive tissue biopsy or bilateral hilar adenopathy on chest imaging. Topical, periocular, and systemic corticosteroids are commonly used to treat ocular sarcoidosis. Chronic cases or refractory cases may warrant immunomodulator therapy. Visual prognosis is contingent on severity of inflammation, time to treatment, and secondary ocular complications. This chapter will discuss the presentation, diagnosis, treatment, and prognosis of patients with ocular sarcoidosis.

Cytomegalovirus retinitis (CMVR) is a severe, vision-threatening disease that primarily affects immunosuppressed patients. CMVR is the most common ocular opportunistic infection in human immunodeficiency virus (HIV) infected patients and is the leading cause of blindness in this group; however, the incidence of CMVR in HIV patients has dramatically decreased with antiretroviral therapy. Other causes of immunosuppression, including organ transplantation, hematologic malignancies, and iatrogenic immunosuppression, can also lead to the development of CMVR. Herein, we describe the pathogenesis of CMVR and compare clinical features, epidemiology, and risk factors in HIV and non-HIV infected individuals with CMVR.