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This abstract is assigned to session AOB Poster session2

Title	Sarcoidosis of orbita and central nervous system presenting as a non-arteritic ischemic optic neuropathy.
Abstract Nr.	2037

Purpose	To describe a patient who presented with non-arteritic ischemic optic neuropathy (NA-AION) as an initial manifestation of neurosarcoidosis.
Methods	A 70-year-old woman who presented with loss of vision in the LE and normal neuroimaging, was initially diagnosed as a NA-AION. An extensive workup included MRI orbita and PET/CT scan.
Results	At the initial presentation, the LE showed loss of vision and papilloedema. Further ophthalmological examination and CT scan of the brain were normal. A diagnosis of NA-AION was entertained. After 4 months, she had no light perception vision. Fundoscopy of the LE showed papilloedema with retinal infiltrates and severe ischaemia. MRI of the brain showed mass infiltration of the intraorbital and the intracranial optic nerve up to the optic chiasm. A complete systemic workup revealed a monoclonal gammopathy with cervical and hilar lymph nodes noted on PET/CT scan. Mediastinoscopy with biopsy of the hilar lymph nodes demonstrated a non-caseating granulomatous lesion and a diagnosis of sarcoidosis was confirmed.
Conclusion	Sarcoidosis is a multisystemic disease characterized by granulomatous inflammation. Uveitis is the most common ocular manifestation. Involvement of the optic nerve, chiasm and visual tract only represent 1-5% of neurosarcoidosis cases. In the latter, sarcoidosis can be initially misdiagnosed as NA-AION, before involvement of the orbit and the CNS. Systemic involvement should be ruled out in any case of AION with an atypical evolution.

Authors 1

Last name	DE BRUYN
Initials	D
Department	Dpt Ophthalmology, Ghent Univ Hosp
City	Ghent

Authors 2

Last name	NINCLAUS
Initials	V
Department	Dpt Ophthalmology, Ghent Univ Hosp
City	Ghent

Authors 3

Last name	LEROY
Initials	BP
Department	Dpt Ophthalmology & Ctr for Med Gen, Ghent Univ Hosp and Children's Hospital of Philadelphia
City	Ghent and Philadelphia

Authors 4

Last name	DE SCHRYVER
Initials	I
Department	Dpt Ophthalmology, Ghent Univ Hosp
City	Ghent

Authors 5

Last name	DE ZAEYTIJD
Initials	J
Department	Dpt Ophthalmology, Ghent Univ Hosp
City	Ghent