Isolated Optic Perineuritis as the Presenting Sign of Sarcoidosis

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Title Isolated Optic Perineuritis as the Presenting Sign of Sarcoidosis
Creator Jonathan A. Micieli; Catherine J. Streutker; Kieran McIntyre
Affiliation Division of Neurology, Department of Medicine, Department of Ophthalmology and Vision Sciences (JAM), University of Toronto, Toronto, Canada; Kensington Vision and Research Centre (JAM), Toronto, Canada; Department of Ophthalmology (JAM), St. Michael's Hospital, Toronto, Canada; Department of Laboratory Medicine (CJS), St. Michael's Hospital, Toronto, Canada; and Division of Respirology (KM), Department of Medicine, University of Toronto, St. Michael's Hospital, Toronto, Canada
Abstract A 35-year-old healthy African-American woman presented with a 4-month history of gradual loss of vision in the right eye from an optic neuropathy. MRI of the orbits with gadolinium showed isolated thickening and enhancement of the right optic nerve sheath. Chest x-ray and CT-scan of the chest were performed and showed bilateral hilar and mediastinal lymphadenopathy. This was suggestive of sarcoidosis, and the diagnosis was confirmed with histopathology. The patient promptly recovered vision with high-dose corticosteroids; the thickening of the optic nerve sheath also regressed. Isolated optic nerve sheath thickening from sarcoidosis is rare and may mimic compressive optic neuropathies such as optic nerve sheath meningiomas. A systemic evaluation for systemic inflammatory etiologies should be considered in such cases.
Subject Adult; Biopsy; Diagnosis, Differential; Female; Humans; Optic Nerve / diagnostic imaging; Optic Neuritis / diagnosis; Optic Neuritis / etiology; Sarcoidosis / complications; Sarcoidosis / diagnosis; Tomography, X-Ray Computed
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Date 2020-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, June 2020, Volume 40, Issue 2
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6jx44cw
Setname ehsl_novel_jno
ID 1592876
Reference URL https://collections.lib.utah.edu/ark:/87278/s6jx44cw
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