Sarcoidosis revealed by simultaneous optic nerve and eyelid involvement: A case report

Buelens, Tom; Scifo, Lisa; Valyi, Z; Willermain, François

doi:10.1016/j.ajoc.2022.101451

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Typical clinical signs of optic neuritis associated with sarcoidosis include subacute or sudden onset of moderate to severe vision loss in the course of unilateral papilledema. Cranial MRI presents hyperintensity on T2 weighted images with contrast enhancement and the presence of granulomas along the optic nerve [10,12]. Due to unremarkable cranial CT scans, cerebral MRI in the first patient was not performed at the onset of the symptoms, hence there was no evaluation of the probable lesions on the optic nerve itself nor the sheath.…”

Section: Discussionmentioning

confidence: 99%

Sudden Vision Loss Due to Optic Neuritis—An Uncommon Presentation of Neurosarcoidosis

Zimna¹,

Szturmowicz²,

Sobiecka³

et al. 2023

Diagnostics

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Sarcoidosis is a systemic, granulomatous disease of unknown etiology, most often manifested by mediastinal and hilar lymph node enlargement and parenchymal nodules in the lungs. However, it may involve any other organ. Neuro-sarcoidosis, a condition that affects up to 20% of sarcoidosis patients, can be found in any part of the central or peripheral nervous system and has important ophthalmic and neuro-ophthalmic manifestations. We present two patients with sudden vision loss due to neurosarcoidosis. In both cases, biopsy of the mediastinal lymph node showed non-caseating granulomas consistent with sarcoidosis. Treatment involved high doses of methylprednisolone intravenously, followed by topical dexamethasone eye drops in the first case and a systemic steroid treatment in the second, resulting in symptom relief. Those two cases demonstrate that sarcoidosis should be considered as a differential diagnosis in cases of optic neuritis.

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Section: Discussionmentioning

confidence: 99%

Sudden Vision Loss Due to Optic Neuritis—An Uncommon Presentation of Neurosarcoidosis

Zimna¹,

Szturmowicz²,

Sobiecka³

et al. 2023

Diagnostics

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“…Second, normal blood levels of antineutrophil cytoplasmic antibodies were not suggestive of antineutrophil cytoplastic antibody-associated vasculitis. Lastly, lacrimal gland biopsy demonstrated normal-appearing tissue, neither showing multiple non-necrotizing granulomas nor abnormally increased plasma cells, which is a hallmark sign of sarcoidosis [ 8 ] and IgG4-related ophthalmic disease, respectively. Therefore, PNS was the probable cause of orbital inflammation, given that orbital myositis affected bilateral extraocular muscles [ 7 , 9 ] and improved significantly after cancer resection [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Orbital Inflammation as a Manifestation of Paraneoplastic Syndrome

Yoshida

Suda

Oishi

et al. 2022

Case Rep Ophthalmol

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Paraneoplastic neurologic syndromes (PNS) constitute a rare group of disorders whose optimal treatment is yet to be established. We report a patient with bilateral orbital inflammation associated with PNS, who responded well to surgical resection of the primary tumor. An 83-year-old woman was referred to our department for treatment of a progressive reduction in visual acuity and palpebral swelling in both eyes for the past 2 months. She was scheduled to undergo thoracic surgery for lung cancer. The best-corrected visual acuity (BCVA) in the right and left eye had worsened from 0.3 to 0.5 one month before she was referred to our department to 0.03 and 0.07, respectively. A slit-lamp examination revealed edema in both eyelids. Goldmann perimetry revealed several paracentral scotomas with constriction of the peripheral visual fields of both eyes, along with central absolute scotomas in V-4e isopter in the right eye. Magnetic resonance imaging revealed swelling of the bilateral extraocular muscles, which compressed the bilateral optic nerves at the orbital apex. Seven days after the resection of the lung cancer, the BCVA improved to 0.07 and 0.15 in the right and left eyes, respectively, without concomitant immunotherapy. Intravenous methylprednisolone (500 mg/day) was administered for 3 days to treat the residual orbital inflammation. Fourteen days after surgery, the BCVA further improved to 0.4 and 0.5 in the right and left eyes, respectively. Swelling of the bilateral extraocular muscles and the visual field abnormalities improved dramatically. Early diagnosis is crucial for the management of PNS.

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“…In the eye, sarcoid can affect many structures including the eyelid, conjunctiva, anterior chamber, retina, and optic nerve. While uveal tract abnormalities are the most common ocular findings, optic nerve involvement has been reported in only 1-5% of patients with sarcoidosis [1]. Diagnosis of ocular sarcoidosis is challenging without the classical features of granulomatous uveitis as outlined by the Revised International Workshop on Ocular Sarcoidosis (IWOS) criteria.…”

Section: Introductionmentioning

confidence: 99%

Neuro-sarcoidosis with isolated optic neuropathy: unmasking the chameleon

Jha,

Pendyala,

Tiwari

2024

Egypt J Intern Med

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Isolated optic nerve involvement is rare in sarcoidosis. We report three cases describing atypical clinical and radiological features of isolated optic nerve involvement in sarcoidosis to expand the spectrum of neuro-ophthalmic sarcoidosis. Bilateral optic neuritis, sudden vision loss, primary optic atrophy, long segment optic neuritis, and isolated intrao-orbital sarcoidosis are described as atypical features of optic nerve involvement in this case series.

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Sarcoidosis revealed by simultaneous optic nerve and eyelid involvement: A case report

Cited by 3 publications

References 19 publications

Sudden Vision Loss Due to Optic Neuritis—An Uncommon Presentation of Neurosarcoidosis

Sudden Vision Loss Due to Optic Neuritis—An Uncommon Presentation of Neurosarcoidosis

Bilateral Orbital Inflammation as a Manifestation of Paraneoplastic Syndrome

Neuro-sarcoidosis with isolated optic neuropathy: unmasking the chameleon

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