[Case of neurosarcoidosis with rapid visual field defect progression].
OBJECTIVE
To report a case of neurosarcoidosis with rapid progression of visual field defects.


METHODS
A 28-year-old woman presented with bilateral uveitis and was diagnosed as having sarcoidosis after skin and cervical lymph node biopsy. Since bilateral excavations of the optic nerve head and visual field defects were observed, endocranial lesion was suspected. However, a computed tomography (CT) scan of the head detected nothing abnormal. It was regarded as a case of sarcoidosisaccompanied by normal-tension glaucoma and treatment was initiated with latanoprost. Four months later, the patient's visual field deteriorated rapidly. A CT scan showed a pituitary mass. Neurologicalfindings and hypopituitarism were found which improved with systemic prednisolone therapy. Diabetes insipidus developed after the start of treatment, and was treated with intranasal desmopressin therapy. After 6 weeks, head magnetic resonance imaging (MRI) showed a remarkable reduction of the enhanced regions.


CONCLUSIONS
Although ocular sarcoidosis is often accompanied by secondary glaucoma or optic nerve atrophy, the progression of neurosarcoidosis can lead to visual field defects. Central nervous system (CNS) sarcoidosis is rare, but a precise examination with enhanced MRI should be considered when the visual field defect progresses rapidly.
Hasumi
Yukiko
Y
Department of Ophthalmology and Visual Sciences, Yokohama City University Graduate School of Medicine, Japan.
Ishihara
Mami
M
Asukata
Yuri
Y
Nishida
Tomomi
T
Hayashi
Kiyofumi
K
Nakamura
Satoshi
S
Mizuki
Nobuhisa
N
D000328:Adult; D002493:Central Nervous System Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage; D020790:Diabetes Insipidus, Neurogenic / Q000188:drug therapy / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011239:Prednisolone / Q000008:administration & dosage; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014605:Uveitis / Q000209:etiology; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D014794:Visual Fields
D011239:Prednisolone; D003894:Deamino Arginine Vasopressin