title: Optic neuropathy associated with systemic sarcoidosis.
abstract: OBJECTIVE
  To identify and follow a series of 52 patients with optic neuropathy related to sarcoidosis.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  RESULTS
  The disorder was more common in women and affected a wide age range. It was proportionately more common in African and Caribbean ethnic groups. Two clinical subtypes were identified: the more common was a subacute optic neuropathy resembling optic neuritis; a more slowly progressive optic neuropathy arose in the remaining 17%. Sixteen (31%) were bilateral. Concurrent intraocular inflammation was seen in 36%. Pain arose in only 27% of cases. An optic perineuritis was seen in 2 cases, and predominate involvement of the chiasm in one. MRI findings showed optic nerve involvement in 75% of cases, with adjacent and more widespread inflammation in 31%. Treatment with corticosteroids was helpful in those with an inflammatory optic neuropathy, but not those with mass lesions. Relapse of visual signs arose in 25% of cases, necessitating an increase or escalation of treatment, but relapse was not a poor prognostic factor.
  
  
  CONCLUSIONS
  This is a large prospective study of the clinical characteristics and outcome of treatment in optic neuropathy associated with sarcoidosis. Patients who experience an inflammatory optic neuropathy respond to treatment but may relapse. Those with infiltrative or progressive optic neuropathies improve less well even though the inflammatory disorder responds to therapy.
authors.affiliation: Departments of Neuro-ophthalmology (D.P.K., B.J.B., E.M.G., G.T.P.), the National Hospital for Neurology and Neurosurgery, The Royal Free Hospital, St Thomas' Hospital, London; James Paget University Hospital (B.J.B.), Great Yarmouth; and University of East Anglia (B.J.B.), Norwich, UK.
authors.forename: Desmond P
authors.initials: DP
authors.lastname: Kidd
authors.affiliation: Departments of Neuro-ophthalmology (D.P.K., B.J.B., E.M.G., G.T.P.), the National Hospital for Neurology and Neurosurgery, The Royal Free Hospital, St Thomas' Hospital, London; James Paget University Hospital (B.J.B.), Great Yarmouth; and University of East Anglia (B.J.B.), Norwich, UK.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Burton
authors.affiliation: Departments of Neuro-ophthalmology (D.P.K., B.J.B., E.M.G., G.T.P.), the National Hospital for Neurology and Neurosurgery, The Royal Free Hospital, St Thomas' Hospital, London; James Paget University Hospital (B.J.B.), Great Yarmouth; and University of East Anglia (B.J.B.), Norwich, UK.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Graham
authors.affiliation: Departments of Neuro-ophthalmology (D.P.K., B.J.B., E.M.G., G.T.P.), the National Hospital for Neurology and Neurosurgery, The Royal Free Hospital, St Thomas' Hospital, London; James Paget University Hospital (B.J.B.), Great Yarmouth; and University of East Anglia (B.J.B.), Norwich, UK.
authors.forename: Gordon T
authors.initials: GT
authors.lastname: Plant