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Abstract #20486 Published in IGR 10-1
Case of neurosarcoidosis with rapid visual field defect progression
Hasumi Y; Ishihara M; Asukata Y; Nishida T; Hayashi K; Nakamura S; Mizuki NNippon Ganka Gakkai Zasshi 2007; 111: 728-734
OBJECTIVE: To report a case of neurosarcoidosis with rapid progression of visual field defects. CASE: A 28-year-old woman presented with bilateral uveitis and was diagnosed as having sarcoidosis after skin and cervical lymph node biopsy. Since bilateral excavations of the optic nerve head and visual field defects were observed, endocranial lesion was suspected. However, a computed tomography (CT) scan of the head detected nothing abnormal. It was regarded as a case of sarcoidosisaccompanied by normal-tension glaucoma and treatment was initiated with latanoprost. Four months later, the patient's visual field deteriorated rapidly. A CT scan showed a pituitary mass. Neurologicalfindings and hypopituitarism were found which improved with systemic prednisolone therapy. Diabetes insipidus developed after the start of treatment, and was treated with intranasal desmopressin therapy. After 6 weeks, head magnetic resonance imaging (MRI) showed a remarkable reduction of the enhanced regions. CONCLUSIONS: Although ocular sarcoidosis is often accompanied by secondary glaucoma or optic nerve atrophy, the progression of neurosarcoidosis can lead to visual field defects. Central nervous system (CNS) sarcoidosis is rare, but a precise examination with enhanced MRI should be considered when the visual field defect progresses rapidly. LA: Japanese
Dr. Y. Hasumi, Department of Ophthalmology and Visual Sciences, Yokohama City University Graduate School of Medicine, Japan
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
