Primary Bilateral Optic Nerve Sarcoidosis

Abstract

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. The nervous system is involved in 5%-15% of patients. In 1%-5% of patients, sarcoidosis affects the optic nerve in some manner. Sarcoid manifesting as an isolated tumor of the optic nerve is uncommon. We report here a 50-yearold woman with primary bilateral optic nerve sarcoidosis. She had a history of progressive, painless visual loss over a 2-month period. Her cerebral magnetic resonance imaging (MRI) scan revealed diffuse thickening and enhancement of the optic chiasm affecting the pre-chiasmatic optic nerves. Surgery was performed for histopathological diagnosis and decompression of the optic nerve. Analysis of a biopsy specimen confirmed a diagnosis of sarcoidosis, and the patient was treated successfully with corticosteroids.

Abdominal sarcoidosis presenting as bilateral simultaneous optic disc granulomas

“…Few cases of sarcoidosis that presented as simultaneous bilateral optic nerve involvement have been reported in the literature and the diagnosis is usually challenging in these cases. [6][7][8] The presence of posterior segment manifestations, such as vitritis in the presented case, may assist in the diagnosis. 7 Abdominal involvement by sarcoidosis is not uncommon.…”