AI Summary & Key Takeaways
AI InsightFurthermore, early diagnosis and timely treatment of neurosarcoidosis are importantfor favorable visual outcomes.
📌 3 Key Takeaways
Abstract
In this study, we present a case of bilateral optic neuropathy and macular ischemia in the right eye associated with neurosarcoidosis.A 26-year-old woman presented to our clinic with complaints of bilateral blurred vision. Bilateral granulomatous anterior uveitis,vitritis, optic neuropathy, and macular ischemia were detected in the right eye in slit-lamp examination. She also reported complaintsof fever, weakness, sweating, arthralgia, and headache for 2 months. She was referred to the pulmonary diseases unit of our hospitaldue to hilar lymphadenopathy seen in her chest x-ray, and biopsies were taken for diagnostic purposes. Histological analysis of themediastinal lymph node biopsies revealed chronic, non-caseating, granulomatous inflammation. Furthermore, the patient was referredto a neurologist due to concomitant complaint of intense headaches. She was diagnosed with neurosarcoidosis supported by findingson cranial magnetic resonance imaging and lumbar puncture. She received a 3-day course of high-dose (1 g/day) intravenous steroidtreatment (methylprednisolone) followed by a tapering dose of oral prednisone. The patient began receiving oral methotrexate 15 mg/week as a steroid-sparing agent. Significant improvement in neurological and ophthalmological symptoms occurred in the first week oftreatment. In this case report, we emphasized that neurosarcoidosis should be included in the differential diagnosis of patients with bothbilateral optic neuropathy and macular ischemia. Furthermore, early diagnosis and timely treatment of neurosarcoidosis are importantfor favorable visual outcomes.