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-year-old 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.