Oprs Images
Compressive Optic Neuropathy From Neurosarcoidosis Erin Lally, M.D.*, Ann P. Murchison, M.D., M.P.H.†, Mark L. Moster, M.D.‡, and Jurij R. Bilyk, M.D.† *Wills Eye Hospital; †Skull Base Division, Neuro-Ophthalmology Service; and ‡Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, U.S.A.
FIG. 1. Axial T1-weighted, post-contrast images of the orbits and brain with fat suppression. Note the widespread, nodular pachymeningitis.
A
42-year-old black woman with previous hydrocephalus and right visual loss to no light perception from neurosarcoidosis presented with progressive left visual loss to 20/200 over 2 weeks. Her sarcoidosis had been diagnosed as a teenager by bronchoscopy. On MRI (Figs. 1 and 2), an enhancing lesion (wide white arrows) compressing and infiltrating the left optic nerve at the optic canal was noted, consistent with a sarcoidal mass. The right intracanalicular optic nerve was atrophic but not involved in the inflammatory process, although its meningeal sheath enhanced mildly (thin white arrow). The anterior
FIG. 2. Coronal T1-weighted, post-contrast images of the skull base and brain with fat suppression.
clinoid process is identified by the black arrow. Diffuse, bulky pachymeningeal sarcoidal lesions were also present in all regions of the brain. The patient’s vision improved to 20/30 on pulsed intravenous methylprednisolone and she was referred to a rheumatologist for maintenance antimetabolite therapy.
Accepted for publication September 9, 2014. The authors have no financial or conflicts of interest to disclose. No identifying images are used for this case and it is HIPAA compliant, thus no patient permission required. Address correspondence and reprint requests to Ann P. Murchison, M.D., M.P.H., Skull Base Division, Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, PA. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000342
Ophthal Plast Reconstr Surg, Vol. 31, No. 3, 2015
e79
Copyright © 2014 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. Unauthorized reproduction of this article is prohibited.
Compressive Optic Neuropathy From Neurosarcoidosis Erin Lally, M.D.*, Ann P. Murchison, M.D., M.P.H.†, Mark L. Moster, M.D.‡, and Jurij R. Bilyk, M.D.† *Wills Eye Hospital; †Skull Base Division, Neuro-Ophthalmology Service; and ‡Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, U.S.A.
FIG. 1. Axial T1-weighted, post-contrast images of the orbits and brain with fat suppression. Note the widespread, nodular pachymeningitis.
A
42-year-old black woman with previous hydrocephalus and right visual loss to no light perception from neurosarcoidosis presented with progressive left visual loss to 20/200 over 2 weeks. Her sarcoidosis had been diagnosed as a teenager by bronchoscopy. On MRI (Figs. 1 and 2), an enhancing lesion (wide white arrows) compressing and infiltrating the left optic nerve at the optic canal was noted, consistent with a sarcoidal mass. The right intracanalicular optic nerve was atrophic but not involved in the inflammatory process, although its meningeal sheath enhanced mildly (thin white arrow). The anterior
FIG. 2. Coronal T1-weighted, post-contrast images of the skull base and brain with fat suppression.
clinoid process is identified by the black arrow. Diffuse, bulky pachymeningeal sarcoidal lesions were also present in all regions of the brain. The patient’s vision improved to 20/30 on pulsed intravenous methylprednisolone and she was referred to a rheumatologist for maintenance antimetabolite therapy.
Accepted for publication September 9, 2014. The authors have no financial or conflicts of interest to disclose. No identifying images are used for this case and it is HIPAA compliant, thus no patient permission required. Address correspondence and reprint requests to Ann P. Murchison, M.D., M.P.H., Skull Base Division, Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, PA. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000342
Ophthal Plast Reconstr Surg, Vol. 31, No. 3, 2015
e79
Copyright © 2014 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. Unauthorized reproduction of this article is prohibited.
![[Compressive optic neuropathy following an inflammatory pseudotumor].](/assets/img/hold.png)
