Neuro-ophthalmic sarcoidosis

Abstract

Sarcoidosis can affect any part of the visual system; the most common neuro-ophthalmic presentation is optic neuropathy. Diagnosing the disease is problematic as the clinical presentation is nonspecific which may be associated with many other pathologies and no diagnostic finding is pathognomonic. In recent years, progress has been made in identifying new biomarkers and developing imaging techniques. Although corticosteroids remain the mainstay of therapy, many new pharmacological agents have been added to the treatment arsenal.

Hypothalamic–pituitary sarcoidosis with vision loss and hypopituitarism: case series and literature review

“…Optic atrophy is the most common neuro-ophthalmologic manifestation of patients with NS [24,25]. In patients with sarcoidosis in general, anterior uveitis is the most common cause of change in vision [26].…”

Visual hallucinations (Charles Bonnet syndrome) associated with neurosarcoidosis

“…[2] Neurosarcoidosis occurs in up to 2-5% of all sarcoidosis patients and can cause cranial neuropathy (particularly peripheral facial nerve palsy), neuroendocrine dysfunction, seizures, encephalopathy, and hydrocephalus. [2] Anterior uveitis and optic neuropathy are the most common ophthalmic manifestations of sarcoidosis, though the disease can affect any component of the eye.…”

“…[2] Neurosarcoidosis occurs in up to 2-5% of all sarcoidosis patients and can cause cranial neuropathy (particularly peripheral facial nerve palsy), neuroendocrine dysfunction, seizures, encephalopathy, and hydrocephalus. [2] Anterior uveitis and optic neuropathy are the most common ophthalmic manifestations of sarcoidosis, though the disease can affect any component of the eye. Visual hallucinations are rarely associated with neurosarcoidosis and a literature search indicated one report of a patient who developed hallucinations secondary to neurosarcoidoisis-induced meningoencephalitis with cognitive impairment, but had no intraocular complications except for mild papilledema.…”

“…[1] Neurosarcoidosis is a multi-systemic inflammatory granulomatous disease affecting both the central and peripheral nervous systems. [2] We report a patient with biopsy-confirmed neurosarcoidosis who experienced CBS. To our knowledge, this is the first such case reported in the English language ophthalmic literature.…”

Sex Disparities in Neuro-Ophthalmologic Disorders

“…148 Neurosarcoidosis has been reported in 5% to 16% of clinical studies, with neuroophthalmic manifestations in about one third of these cases. 149 Vision loss from sarcoid optic neuropathy is a common manifestation of neurosarcoidosis. Less commonly, sarcoidosis can also cause diplopia by affecting the oculomotor, trochlear or abducens nerves.…”