[Bilateral optic neuropathy revealing systemic sarcoidosis].

INTRODUCTION

Although ocular involvement concerns about 25 to 60% of patients with systemic sarcoidosis, papilledema is a rare event.

EXEGESIS: A 43-year-old man presented with left visual loss related to papillitis. Despite high-dose corticosteroids, visual loss became rapidly bilateral. Thoracic CT-scan showed mediastinal and parenchymal involvement. Histological study of lung, bronchial and lymphadenopathy biopsies displayed giant-cells granuloma without necrosis. Diagnosis of sarcoidosis complicated with optic neuropathy was made. Therapy combining prednisone, methotrexate and infliximab was started without significant improvement of visual acuity.

CONCLUSION

This report underlines the potential severity of optic neuropathy in sarcoidosis.