| Sarcoidosis of the anterior visual pathway: 24 new cases. | |
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MedLine Citation:
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PMID: 14504590 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To describe the clinical spectrum and a rational approach to the diagnosis of anterior visual pathway sarcoidosis. METHODS: Retrospective chart review of all patients examined in neuro-ophthalmic consultation by 1 author from 1989 to 1998 with a diagnosis of sarcoidosis. RESULTS: There were 24 patients (17 female, 7 male, mean age 40 years) with anterior visual pathway sarcoidosis, 17 (71%) of whom were not previously known to have sarcoidosis. Visual acuity ranged from 20/20 to NLP. Normal fundi were observed in 15%. Among the 85% who had fundus abnormalities, pallor was present in 55%, disc edema in 26%, periphlebitis/sheathing in 14%, and optic disc granuloma in 10%. Ten patients (42%) had uveitis, active in only 3 (13%). An elevated angiotensin-converting enzyme (ACE) was present in 16 (76%) of 21 patients tested; evidence of sarcoidosis on chest radiograph was present in 13 (72%) of 18; gallium scanning was abnormal in 13 (93%) of 14; neuroimaging abnormalities of the optic nerves, chiasm, or tract were present in 16 (70%) of 23; lymphocytic pleocytosis or elevated cerebrospinal fluid protein was identified in 14 (88%) of 16 patients, with both values elevated in 7 (44%) patients. Histologic confirmation was obtained in 13 (81%) of 16 who underwent biopsy; in the remaining patients, diagnosis was based entirely on clinical and laboratory evidence. CONCLUSIONS: Anterior visual pathway disease may be underrecognized as a presentation of sarcoidosis. Classic fundus findings of periphlebitis and optic granuloma are typically absent. An aggressive diagnostic evaluation may help establish the diagnosis early in its course. |
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Authors:
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Larry P Frohman; Medhat Guirgis; Roger E Turbin; Leonard Bielory |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society Volume: 23 ISSN: 1070-8022 ISO Abbreviation: J Neuroophthalmol Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-23 Completed Date: 2003-11-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9431308 Medline TA: J Neuroophthalmol Country: United States |
Other Details:
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Languages: eng Pagination: 190-7 Citation Subset: IM |
Affiliation:
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Institute of Ophthalmology and Visual Sciences, UMDNJ-New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA. Frohman@umdnj.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Diagnostic Techniques, Ophthalmological* Eye Diseases / diagnosis, etiology Female Humans Magnetic Resonance Imaging Male Middle Aged Optic Nerve Diseases / complications, diagnosis* Sarcoidosis / complications, diagnosis* Visual Acuity Visual Pathways / pathology* |
| Comments/Corrections | |
Comment In:
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J Neuroophthalmol. 2003 Sep;23(3):187-9
[PMID:
14504589
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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