title: Sarcoidosis of the anterior visual pathway: successes and failures.
abstract: Four patients with progressive visual deterioration were found to have sarcoidosis involving the anterior visual pathway. They all developed chiasmal dysfunction and bilateral optic neuropathy, which responded to megadose corticosteroid therapy. When an attempt was made to withdraw the corticosteroids, the patients experienced a recrudescence of visual dysfunction and were subsequently unable to tolerate the corticosteroid dose levels necessary to maximise their visual potential. Each patient was treated with high-voltage radiation therapy, totalling up to 4500 rads. The beneficial response obtained was temporary, and immunosuppressive therapy with azathioprine or chlorambucil was instituted, preventing further deterioration.
authors.affiliation: Department of Neurology, New York University Medical Center, NY.
authors.forename: M J
authors.initials: MJ
authors.lastname: Gelwan
authors.forename: R I
authors.initials: RI
authors.lastname: Kellen
authors.forename: R M
authors.initials: RM
authors.lastname: Burde
authors.forename: M J
authors.initials: MJ
authors.lastname: Kupersmith
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003399:Craniotomy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000532:radiotherapy; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity / Q000187:drug effects; D014795:Visual Pathways / Q000000981:diagnostic imaging / Q000187:drug effects / Q000528:radiation effects
chemical_list: D000305:Adrenal Cortex Hormones; D001379:Azathioprine