[Sarcoidosis of the optic nerve].
BACKGROUND
Rarely an affection of the optic nerve is seen as the initial or only manifestation of sarcoidosis. Therefore the disease is often diagnosed late. The aim of systemic corticosteroid therapy is to prevent progression though it cannot yield a cure.


METHODS
Despite a high-dose corticosteroid therapy in suspected optic neuritis a 25-year-old woman developed unilateral amaurosis. When visual acuity continuously decreased in the second eye a computerized tomography was performed, which suggested a tumor of the optic nerve. A biopsy of this lesion lead to the diagnosis of Boeck's disease. A long-term corticosteroid therapy was initiated. Over the following 9-year period corticosteroids were dosed according to the results of regular clinical and perimetrical examinations (200 examinations with Octopus-Perimeter 201, program G1). In case of deterioration of the visual field higher oral doses were applied. When no improvement was achieved by this, corticosteroids were given intrathecally. Under this therapeutic regime no systemic side effects were seen.


CONCLUSIONS
In unilateral visual loss Boeck's disease should be considered as a rare etiology. In case of clear optical media frequent computerized perimetry allows the neurologist to adjust the dosage of cortisone and minimize its side effects.
Sader
A
A
Universitätsaugenklinik Würzburg.
Gramer
E
E
Körner
U
U
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D001706:Biopsy; D003952:Diagnostic Imaging; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009900:Optic Nerve / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
D000305:Adrenal Cortex Hormones
Sarkoidose des Nervus opticus.