Dr. ASHOK KUMAR

Dr.Sanjay Kumar Mishra, Dr. MAYANK JHANWAR

Abstract

Purpose

To report a rare presentation of neuro-ophthalmic sarcoidosis as disc granuloma with retinal vein occlusion in undiagnosed sarcoidosis patient.

Methods

45 year old lady, presented with diminution of vision in left eye. Fundus examination showed large optic disc granuloma with occlusion of supero-temporal retinal vein which was confirmed on Fundus fluroscein angiography and USG- B-scan. She had elevated serum ACE levels and CECT of chest revealed hilar lymphadenopathy which on biopsy confirmed sarcoidosis.

Results

Patient was managed with oral steroids as well as immunosuppressive agents with significant reduction in size of granuloma but minimal improvement in vision.

Conclusion

Neuro-ophthalmic sarcoidosis is relatively rare subset and can manifest with rare presentation where ocular symptoms can appear before systemic involvement. Prompt diagnosis and appropriate treatment in conjunction with an internist can enable clinicians in the efficient management of these patients.