Sarcoid optic neuropathy

Sarcoidosis is a multisystem granulomatous disease mostly involving the che st. Sarcoid optic neuropathy is an uncommon but serious manifestation that requires long-term corticosteroid treatment. We report here the case of a 50-year-old black patient complaining of a rec ent blurred Vision on his left eye. The ophthalmologic examination was norm al, Goldmann visual field and visual evoked potentials confirmed the diagno sis of retrobulbar optic neuropathy. Sarcoidosis was presumed on a chest ra diography and computed tomography and confirmed with a transbronchial biops y. Symptoms disappeared with intravenous bolus of corticosteroids. Three mo nths later, without treatment, a right inferior eyelid tumor was observed. Magnetic resonance imaging (RMI) showed two orbital masses and multiple men ingeal lesions enhancing with contrast suggesting neurosarcoidosis wich dec reased with a long-term high-dose corticosteroid therapy (1 mg/kg/d). Optic neuropathy is a rare manifestation of neurosarcoidosis, mostly accomp anied by optic-disc involvement with papillary lesions. Chest roentgenogram and computed tomography give a presumption of sarcoidosis; But biopsy is m andatory to confirm the diagnosis demonstrating the histologic lesion of a non caseating granulomatous. Corticosteroid therapy is dramatically efficie nt but sometimes several months treatment is required.