Sarcoidosis of the Optic Nerve and Tract: Prolonged Enhancement with Gadolinium on MRI

Sarcoidosis is a multi-system inflammatory condition characterized by non-caseating granulomata, which involves the central nervous system in 5-15%. Visual loss can occur through involvement of the optic nerves, chiasm or tracts, as these are closely related to the basal meninges, a common site of lesions. We describe three patients with histopathology consistent with sarcoidosis and without evidence for other granu lomatous conditions, in whom M R imaging with gadolinium- DPTA showed enhancing lesions of the visual pathways.