The purpose of this paper is to report two cases of
sarcoidosis with conflicting signs in which vitreous cytology was useful for supporting the diagnosis. Case 1 was a 56-year-old man who was referred with blurred vision, and was found to have
iridocyclitis, vitreous opacities, and
optic neuritis bilaterally. He also had a swelling of both mandibular glands. He received pulsed
corticosteroid therapy, but the vitreous opacities and
papilledema did not resolve. The second case was a 77-year-old man referred with blurred vision, and both eyes had snowball-like vitreous opacities and
optic neuritis. The ocular findings in both cases strongly suggested
sarcoidosis, but the systemic findings did not meet the diagnostic criteria for
sarcoidosis. We performed pars plana
vitrectomy to remove the vitreous opacities, and the collected vitreous samples were sent for cytological analyses. Epithelioid and multinucleated giant cells pathognomonic of
sarcoidosis were found in the vitreous samples which enabled us to make a diagnosis of
sarcoidosis. Vitreous cytology can help in supporting a diagnosis of
sarcoidosis, especially in cases of ocular
inflammation suggesting
sarcoidosis but systemic findings that do not satisfy the diagnostic criteria for this disease.