May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Location of Radiographic Optic Nerve Involvement as a Predictor of Visual Outcome in Sarcoid Optic Neuropathy
Author Affiliations & Notes
  • H. J. Kim
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • F. Levin
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • R. E. Turbin
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • L. Wolansky
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • L. Bielory
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • L. P. Frohman
    Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • Footnotes
    Commercial Relationships  H.J. Kim, None; F. Levin, None; R.E. Turbin, None; L. Wolansky, None; L. Bielory, None; L.P. Frohman, None.
  • Footnotes
    Support  Research to Prevent Blindness, Inc, NY; Lions Eye Research Foundation of NJ.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 6017. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      H. J. Kim, F. Levin, R. E. Turbin, L. Wolansky, L. Bielory, L. P. Frohman; Location of Radiographic Optic Nerve Involvement as a Predictor of Visual Outcome in Sarcoid Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6017. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : To evaluate whether the location of optic nerve (ON) involvement on magnetic resonance imaging (MRI) prognosticates visual outcome in patients with sarcoid optic neuropathy.

Methods: : Retrospective chart review of cases of sarcoid optic neuropathy seen by two of the authors (LF and RT) between 1989 and 2007 was performed. Only those patients who had a final clinical or histological diagnosis of sarcoid optic neuropathy and had their pre-treatment MRI performed at UMDNJ-NJMS after 1/1/93 were included. Each scan was categorized into normal study, involvement of anterior (distal 1 cm of optic nerve in the orbit), posterior (rest of the orbital optic nerve), intracanalicular, and intracranial ON, or involvement of optic chiasm or tract.

Results: : Seven patients’ charts and scans were recovered who met the study inclusion criteria (4 female, 3 male, mean age 40). Initial and final visual acuity ranged from 20/20 to no light perception (NLP). Afferent pupillary defects were apparent in all patients at presentation and in 2 at the final visit. Magnetic resonance imaging results revealed one normal, 5 unilateral, and one bilateral optic nerve enhancement. The patient whose imaging was normal required no treatment with spontaneous resolution of vision from hand motion (HM) to 20/20. Among the 5 unilateral cases, one patient with anterior ON involvement and another with posterior orbital and intracanalicular ON involvement recovered 20/20 vision from HM and 20/400 vision, respectively, after treatment with corticosteroids alone. The 3 remaining patients had unilateral orbital ON involvement extending to the chiasm. One of these patients had improvement of vision from counting fingers (CF) to 20/400 after receiving methotrexate and steroids. The other two had final acuity of NLP; one never received any treatment, and the other received solumedrol, kenalog and optic nerve irradiation. The bilateral case was treated with steroids and cyclosporine; the vision improved from 20/80 (right eye) and CF (left eye) to 20/20 and 20/25, respectively.

Conclusions: : The location of radiographic ON involvement may play a role in predicting the final visual outcome in sarcoid optic neuropathy. This may be a consideration in choosing the initial therapeutic regimen.

Keywords: neuro-ophthalmology: optic nerve • imaging/image analysis: clinical • immunomodulation/immunoregulation 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×