Bilateral optic disk edema caused by sarcoidosis mimicking pseudotumor cerebri

PURPOSE: To present a case of retrobulbar optic nerve and chiasm sarcoidosi s that mimicked pseudotumor cerebri. METHODS: A 34 year-old, thin, black woman presented with transient visual o bscurations, normal visual acuity, bilateral optic disk edema, and enlarged blind spots. Clinical, medical, and radiologic evaluations were consistent with pseudotumor cerebri, The patient improved while taking acetazolamide, but 6 months later her symptoms worsened. Neuroimaging disclosed enhanceme nt of the optic nerve and chiasm, RESULTS: Despite administration of intravenous corticosteroids, the patient 's vision worsened, Bilateral optic nerve sheath fenestrations were perform ed, and pathology disclosed sarcoidosis, CONCLUSION: Sarcoidosis of the optic nerves and chiasm may mimic pseudotumo r cerebri, (Am J Ophthalmol 1999;127:229-230. (C) 1999 by Elsevier Science Inc. All rights reserved.).