Giovanni Campagna1, Claudia M Prospero Ponce2, Aroucha Vickers3, Bennett Yau-Bun Hong4, Francesco Pellegrini5, Daniele Cirone6, Francesco Romano5, Piernicola Machin7, Andrew G Lee3,4,8,9. 1. School of Medicine, Baylor College of Medicine, Houston, Texas, USA. 2. Department of Pathology and Genomic Medicine, Ocular Pathology, Houston Methodist Hospital, Houston, Texas, USA. 3. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA. 4. Department of Ophthalmology and Visual Sciences, The University of Texas Medical Branch, Galveston, Texas, USA. 5. Neuro-Ophthalmology Service, Department of Ophthalmology, De Gironcoli Hospital, Conegliano, Italy. 6. Uveitis Service, Department of Ophthalmology, Clinica Villa Anna, San Benedetto del Tronto, Italy. 7. Department of Pathology, Conegliano Hospital, Conegliano, Italy. 8. Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York City, New York, USA. 9. Department of Ophthalmology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Abstract
Background: In the absence of confirmatory biopsy, the criteria for diagnosis of neuro-ophthalmic sarcoidosis are not well established. Diagnostic criteria for both intraocular sarcoidosis and neurosarcoidosis have been proposed, but the diagnosis of neuro-ophthalmic sarcoidosis remains challenging. It is our intention to augment what is currently known about the diagnosis of neuro-ophthalmic sarcoidosis by providing a series of biopsy-proven cases that contribute to the continued development of diagnostic criteria for this enigmatic condition. Methods: Case series of four Caucasian women with biopsy-proven neuro-ophthalmic sarcoidosis. Results: The first patient was initially diagnosed with traumatic optic neuropathy following a fall. Years later, the presence of pathologic submandibular lymphadenopathy was identified and biopsied, revealing non-caseating granulomas. The second and third cases involved sarcoidosis of the extraocular muscles without clear or common systemic features of sarcoidosis. In the fourth and final case, the patient presented with a Horner syndrome attributed to sarcoid infiltration of the ipsilateral sympathetic chain. Bronchoscopy with biopsy showed non-caseating granulomas consistent with sarcoidosis. Conclusions: We describe four cases of neuro-ophthalmic sarcoidosis and propose possible neuro-orbital and neuro-ophthalmic criteria both with and without diagnostic biopsy.
Background: In the absence of confirmatory biopsy, the criteria for diagnosis of neuro-ophthalmic sarcoidosis are not well established. Diagnostic criteria for both intraocularsarcoidosis and neurosarcoidosis have been proposed, but the diagnosis of neuro-ophthalmic sarcoidosis remains challenging. It is our intention to augment what is currently known about the diagnosis of neuro-ophthalmic sarcoidosis by providing a series of biopsy-proven cases that contribute to the continued development of diagnostic criteria for this enigmatic condition. Methods: Case series of four Caucasian women with biopsy-proven neuro-ophthalmic sarcoidosis. Results: The first patient was initially diagnosed with traumatic optic neuropathy following a fall. Years later, the presence of pathologic submandibular lymphadenopathy was identified and biopsied, revealing non-caseating granulomas. The second and third cases involved sarcoidosis of the extraocular muscles without clear or common systemic features of sarcoidosis. In the fourth and final case, the patient presented with a Horner syndrome attributed to sarcoid infiltration of the ipsilateral sympathetic chain. Bronchoscopy with biopsy showed non-caseating granulomas consistent with sarcoidosis. Conclusions: We describe four cases of neuro-ophthalmic sarcoidosis and propose possible neuro-orbital and neuro-ophthalmic criteria both with and without diagnostic biopsy.
Authors: Y Hayashi; Yoshiki Ishii; J Nagasawa; S Arai; H Okada; F Ohmi; T Umetsu; Y Machida; K Kurasawa; A Takemasa; S Suzuki; T Senoh; T Sada; K Hirata Journal: Sarcoidosis Vasc Diffuse Lung Dis Date: 2016-10-07 Impact factor: 0.670
Authors: Jacob J Koczman; Jacinthe Rouleau; Morgan Gaunt; Randy H Kardon; Michael Wall; Andrew G Lee Journal: Semin Ophthalmol Date: 2008 May-Jun Impact factor: 1.975