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Neuro-Ophthalmic Manifestations of Sarcoidosis: Clinical Spectrum, Evaluation, and Management

2001; Lippincott Williams & Wilkins; Volume: 21; Issue: 2 Linguagem: Inglês

10.1097/00041327-200106000-00016

1536-5166

Larry Frohman, R.A. Grigorian, Leonard Bielory,

Amyloidosis: Diagnosis, Treatment, Outcomes

Objective To familiarize the reader with the neuro-ophthalmic manifestations of sarcoidosis. Materials and Methods All patients underwent systemic evaluations (chest radiograph, magnetic resonance imaging and/or computed tomography, serum angiotensin-converting enzyme level, and gallium scan). Histologic confirmation was preferred (11 of 15 patients underwent biopsy, ten of whom [82%] had positive biopsies, and four refused). Otherwise, the diagnosis of clinical sarcoidosis was based on laboratory evaluation. Results We report our experience with 15 patients who had neuro-ophthalmic manifestations of sarcoidosis other than optic neuropathy or chiasmal disease. Eight of 15 (53%) did not have known sarcoidosis at the time of presentation. Thirteen of 15 (87%) patients demonstrated lesions consistent with sarcoidosis on magnetic resonance imaging of the brain. Treatment with corticosteroids and/or other immunomodulatory agents was necessary in all cases. Conclusions Neuro-ophthalmic manifestations of sarcoidosis are rare. They may be the presenting signs of otherwise occult disease. Suspicion and inclusion in the differential are a key to establishing the diagnosis. A strategy for the detection and evaluation of these cases is presented.