Sarcoid Optic Neuropathy

  • An-Guor Wang


A 52-year-old female presented with complaints of blurred vision OS for 2 months. She had a past medical history of peptic ulcers. She also suffered multiple skin rashes over her face (Fig. 55.1) and abdomen starting 1 year ago. Skin biopsy at another hospital showed granulomatous inflammation with mononuclear cell infiltration, which was diagnosed as sarcoidosis. She also received a chest CT scan which revealed subpleural centrilobular nodules with interstitial thickening in the left lower lobe, which was suspected to be alveolar sarcoidosis.


  1. 1.
    Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357(21):2153–65.CrossRefPubMedGoogle Scholar
  2. 2.
    Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183(5):573–81.CrossRefPubMedGoogle Scholar
  3. 3.
    Thomas KW, Hunninghake GW. Sarcoidosis. JAMA. 2003;289(24):3300–3.CrossRefPubMedGoogle Scholar
  4. 4.
    Nozaki K, Judson MA. Neurosarcoidosis. Curr Treat Options Neurol. 2013;15(4):492–504.CrossRefPubMedGoogle Scholar
  5. 5.
    Segal BM. Neurosarcoidosis: diagnostic approaches and therapeutic strategies. Curr Opin Neurol. 2013;26(3):307–13.CrossRefPubMedGoogle Scholar
  6. 6.
    Hoitsma E, Faber CG, Drent M, Sharma OP. Neurosarcoidosis: a clinical dilemma. Lancet Neurol. 2004;3(7):397–407.CrossRefPubMedGoogle Scholar
  7. 7.
    Allen RK, Sellars RE, Sandstrom PA. A prospective study of 32 patients with neurosarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2003;20(2):118–25.PubMedGoogle Scholar
  8. 8.
    Fritz D, van de Beek D, Brouwer MC. Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis. BMC Neurol. 2016;16(1):220.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Heiligenhaus A, Wefelmeyer D, Wefelmeyer E, Rosel M, Schrenk M. The eye as a common site for the early clinical manifestation of sarcoidosis. Ophthalmic Res. 2011;46(1):9–12.CrossRefPubMedGoogle Scholar
  10. 10.
    Rothova A, Alberts C, Glasius E, Kijlstra A, Buitenhuis HJ, Breebaart AC. Risk factors for ocular sarcoidosis. Doc Ophthalmol. 1989;72(3–4):287–96.CrossRefPubMedGoogle Scholar
  11. 11.
    Rothova A. Ocular involvement in sarcoidosis. Br J Ophthalmol. 2000;84(1):110–6.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Atmaca LS, Atmaca-Sonmez P, Idil A, Kumbasar OO, Celik G. Ocular involvement in sarcoidosis. Ocul Immunol Inflamm. 2009;17(2):91–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Ohara K, Okubo A, Sasaki H, Kamata K. Intraocular manifestations of systemic sarcoidosis. Jpn J Ophthalmol. 1992;36(4):452–7.PubMedGoogle Scholar
  14. 14.
    Pasadhika S, Rosenbaum JT. Ocular sarcoidosis. Clin Chest Med. 2015;36(4):669–83.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Kidd DP, Burton BJ, Graham EM, Plant GT. Optic neuropathy associated with systemic sarcoidosis. Neurol Neuroimmunol Neuroinflamm. 2016;3(5):e270.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Graham EM, Ellis CJ, Sanders MD, McDonald WI. Optic neuropathy in sarcoidosis. J Neurol Neurosurg Psychiatry. 1986;49(7):756–63.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Prasse A. The diagnosis, differential diagnosis, and treatment of sarcoidosis. Dtsch Arztebl Int. 2016;113(33–34):565–74.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Ing EB, Garrity JA, Cross SA, Ebersold MJ. Sarcoid masquerading as optic nerve sheath meningioma. Mayo Clin Proc. 1997;72(1):38–43.CrossRefPubMedGoogle Scholar
  19. 19.
    Brito-Zerón P, Pérez-Alvarez R, Pallarés L, Retamozo S, Baughman RP, Ramos-Casals M, SarcoGEAS-SEMI Study Group. Sarcoidosis: an update on current pharmacotherapy options and future directions. Expert Opin Pharmacother. 2016;17(18):2431–48.CrossRefPubMedGoogle Scholar
  20. 20.
    Baughman RP, Lower EE, Ingledue R, Kaufman AH. Management of ocular sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2012;29(1):2633.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • An-Guor Wang
    • 1
  1. 1.Department of OphthalmologyTaipei Veterans General Hospital, National Yang-Ming University School of Medicine, Yun-San Ophthalmology Education Research FoundationTaipeiTaiwan

Personalised recommendations