Association of inflammatory eye disease with granuloma annulare?

T o our knowledge, 3 reports in the literature document the presence of uveitis in patients with granuloma annulare (GA) (Table). Oz et al first reported this association in a 51-year-old woman with anterior uveitis, an inflammatory disease of the iris and ciliary body. Rahimi and Moinfar later reported a similar case of anterior uveitis and biopsy-proven GA. Resolution of both skin and ocular disease occurred after administration of topical and systemic corticosteroids; however, these 2 patients relapsed once topical and systemic steroids were tapered. In the largest study to date, van Kooij et al described 8 patients with bilateral, chronic, intermediate uveitis and biopsy-proven localized GA. Of note, intermediate uveitis is much less common than anterior uveitis and is characterized by inflammation of the peripheral retina, pars plana, and vitreous rather than of the anterior uvea. Seven of the patients described had evidence of severe retinal vasculitis complicated by cystoid macular edema, cataract, and glaucoma. One patient required laser photocoagulation for treatment of ischemic retinopathy secondary to vasculitis. These authors proposed that patients diagnosed with GA should undergo a screening evaluation for uveitis and that ophthalmologists should become familiar with the classic presentation of GA. These reports prompted us to question whether screening a cohort of patients with GA would reveal any past or present evidence of uveitis.