Bilateral optic disk edema caused by sarcoidosis mimicking pseudotumor cerebri

Am J Ophthalmol. 1999 Feb;127(2):229-30. doi: 10.1016/s0002-9394(98)00351-1.


Purpose: To present a case of retrobulbar optic nerve and chiasm sarcoidosis that mimicked pseudotumor cerebri.

Methods: A 34-year-old, thin, black woman presented with transient visual obscurations, normal visual acuity, bilateral optic disk edema, and enlarged blind spots. Clinical, medical, and radiologic evaluations were consistent with pseudotumor cerebri. The patient improved while taking acetazolamide, but 6 months later her symptoms worsened. Neuroimaging disclosed enhancement of the optic nerve and chiasm.

Results: Despite administration of intravenous corticosteroids, the patient's vision worsened. Bilateral optic nerve sheath fenestrations were performed, and pathology disclosed sarcoidosis.

Conclusion: Sarcoidosis of the optic nerves and chiasm may mimic pseudotumor cerebri.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Optic Chiasm / pathology*
  • Optic Nerve Diseases / complications*
  • Optic Nerve Diseases / diagnosis*
  • Optic Nerve Diseases / surgery
  • Papilledema / etiology*
  • Pseudotumor Cerebri / diagnosis*
  • Sarcoidosis / complications*