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Optic nerve sarcoidosis: MR findings

J D Engelken1, W T Yuh, K D Carter

  • 1Department of Radiology, University of Iowa College of Medicine, Iowa City 52242.

Insights

Sarcoidosis rarely affects the optic nerves directly. Magnetic Resonance Imaging (MRI) revealed isolated optic nerve sarcoid involvement in two patients with biopsy-proven disease.

Area of Science:

  • Neurology
  • Ophthalmology
  • Radiology

Background:

  • Sarcoidosis is a multisystem inflammatory disease.
  • Neurologic involvement occurs in approximately 5% of sarcoidosis cases.
  • Isolated optic nerve granulomatous involvement is an uncommon presentation.

Observation:

  • Two patients with biopsy-proven sarcoidosis presented with optic nerve dysfunction.
  • Fat-suppressed gadolinium-enhanced Magnetic Resonance Imaging (MRI) was utilized for diagnostic evaluation.
  • Imaging findings were specific for granulomatous inflammation confined to the optic nerves.

Findings:

  • The MRI findings demonstrated direct sarcoid involvement limited to the optic nerves.
  • The optic chiasm was not affected in either patient.
  • This presentation highlights a rare manifestation of neurosarcoidosis.

Implications:

  • Early and accurate diagnosis of optic nerve sarcoidosis is crucial for timely treatment.
  • Advanced imaging techniques like contrast-enhanced MRI are valuable in diagnosing localized neurosarcoidosis.
  • Understanding these rare presentations aids in managing patients with sarcoidosis and visual disturbances.

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