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Neuro-ophthalmic sarcoidosis

Authors Baughman R, Weiss, Golnik

Received 22 December 2011

Accepted for publication 1 February 2012

Published 14 March 2012 Volume 2012:4 Pages 13—25


Review by Single-blind

Peer reviewer comments 3

Robert P Baughman1, Kenneth L Weiss2, Karl C Golnik3

1Department of Medicine, 2Department of Radiology, 3Department of Ophthalmology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA

Abstract: Neuro-ophthalmic disease occurs in about a third of patients with neurosarcoidosis. Optic nerve involvement is the most common manifestation, but other cranial nerves and the optic chiasm can be involved. However, there are several other common diseases that cause optic neuropathy, including multiple sclerosis. The diagnosis of sarcoidosis can often be made based on the multi-organ nature of the disease and ancillary testing. Most patients with neuro-ophthalmic sarcoidosis require systemic therapy. While corticosteroids are usually the first step in therapy, cytotoxic agents such as methotrexate and azathioprine have been useful as steroid-sparing agents for chronic disease. The monoclonal antibodies directed against tumor necrosis factor have been reported as effective in refractory cases of neuro-ophthalmic disease.

Keywords: sarcoidosis, methotrexate, infliximab, multiple sclerosis, optic neuritis, prednisone

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