View abstract

This abstract is assigned to session AOB Poster session2

Title	Optic neuropathy diagnose neurosarcoidosis: 4 new cases in 2014-2015
Abstract Nr.	2042

Purpose	To present and discuss the clinical features and therapy management of 4 patients with severe optic neuropathy confirmed by tissue biopsy to be a neurosarcoidosis.
Methods	Retrospective reviewed of 4 cases collected between 2014-2015. Clinical ophthalmological, systemic and radiological features will be discussed. Therapeutic management will be presented and discussed with the recent therapeutic recommendations.
Results	All patients (4 females, from 42 to 68 yo) were Caucasians, complained of severe, progressive, slightly painful and unilateral visual loss in 3 patients. Bilateral concurrent optic neuropathy was reported in 2 patients. Subsequent contralateral optic nerve involvement happened in 2 patients during corticosteroids tapering or after several months of treatment discontinuation. Visual field defects were characterized by deep central, paracentral and fascicular scotomas. Three patients had an optic swelling without any uveitis. None had associated systemic symptoms. Biology tests were poorly contributive. All patients were first started under oral or IV corticosteroids, but with variable response. One patient had a significant improvement with the Infliximab.
Conclusion	Frequency of neuro-ophthalmic manifestations in neurosarcoidosis is not known but optic nerve involvement ranges from 1 to 5%. Clinical presentation of optic neuropathy is aspecific and tissue biopsy is mandatory to confirm the diagnosis. Response to corticosteroids is variable and absence of visual improvement after high dosage of methylprednisolone has been observed in our series as in the literature. There is no established guideline in case of failed corticotherapy. Infliximab seems to give interesting results.

Authors 1

Last name	RABEUX
Initials	E
Department	Cliniques Universitaires Saint Luc
City	Bruxelles

Authors 2

Last name	Boschi
Initials	A
Department	Cliniques Universitaires Saint Luc
City	Bruxelles