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Case Reports
. 2017;34(2):179-183.
doi: 10.36141/svdld.v34i2.5410. Epub 2017 Apr 28.

Isolated optic nerve sarcoidosis

Sandip Suresh  1 , Gregory S Kosmorsky  2 , Michael S Lee  1   3
Affiliations
Case Reports

Isolated optic nerve sarcoidosis

Sandip Suresh et al. Sarcoidosis Vasc Diffuse Lung Dis. 2017.

Abstract

Objective: To report three cases of sarcoidosis confined to the optic nerve. Methods: Chart review of clinical, laboratory, imaging, and optic nerve biopsy findings and a review of the literature. Results: All three cases presented with progressive visual loss and showed enhancement of the intraorbital optic nerve on magnetic resonance imaging. There was no evidence for systemic disease, including a negative workup for sarcoidosis or other infiltrative pathologies. Optic nerve biopsy in each case showed non-caseating granulomas consistent with sarcoidosis. Conclusions: Sarcoidosis confined to the optic nerve is a rare phenomenon but should still be considered in the differential diagnosis of progressive optic neuropathy, even in the absence of systemic disease. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 179-183).

Keywords: optic nerve; optic neuritis; optic neuropathy; sarcoidosis.

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Figures

Fig. 1.
Fig. 1.
[Case 1]: A) Fundus photographs show severe disc edema extending into the macula in the right eye. Hemorrhages around the disc and within the macula are also visible. The left eye is normal. B) Contrast enhanced T1-weighted brain and orbit MRI. Axial section shows enhancement of the intraorbital right optic nerve with edema extending to the optic chiasm. Coronal view shows involvement of the right optic nerve without lesions in the brain parenchyma or meninges. C) Haematoxylin and eosin stain of optic nerve biopsy specimen. Low power view shows numerous well-formed non-caseating granulomas consistent with sarcoidosis. High power view of non-caseating granulomas
Fig. 2.
Fig. 2.
[Case 2]: A) Fundus photographs show severe swelling of the disc with surrounding hemorrhage. The left eye is normal. B) Contrast enhanced axial T1-weighted brain and orbit MRI. Intense enhancement of the right intraorbital right optic nerve can be seen in conjunction with partial enhancement of the left intraorbital optic nerve
Fig. 3.
Fig. 3.
[Case 3]: Contrast enhanced axial T1-weighted MRI of head and orbit. Isolated enhancement of the right optic nerve is visible beginning in the posterior orbit and extending to the intracranial portion
See this image and copyright information in PMC

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