National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
Neurology and Neuro-Ophthalmology, Bethesda Neurology, Rockville, Maryland, USA.
Ocul Immunol Inflamm. 2024 Feb;32(2):175-177. doi: 10.1080/09273948.2022.2127783. Epub 2022 Oct 12.
To report a case of an optic disc granuloma secondary to sarcoidosis in the absence of any systemic symptoms nor evident signs of intraocular inflammation at the time of presentation.
Retrospective case report.
A 59-year-old Caucasian woman with previously unrevealing systemic work up was referred to the uveitis service for persistent optic disc edema of the right eye for over 1 year. Fundoscopic examination revealed an optic disc granuloma with associated hyper-reflectivity on OCT and high surface reflectivity with medium internal reflectivity on B-scan ultrasound. CT chest was negative, however, a PET scan demonstrated extensive FDG activity in the mediastinum and bilateral hilum, consistent with a diagnosis of sarcoidosis.
Optic nerve head granulomas can rarely present as the only clinical sign of sarcoidosis. In these cases, additional imaging modalities may be needed to make the appropriate diagnosis.
报告一例继发于结节病的视盘肉芽肿，患者在就诊时既无全身症状，也无明显的眼内炎症迹象。
回顾性病例报告。
一名 59 岁白人女性，此前全身检查未见异常，因右眼持续性视盘水肿超过 1 年，被转诊至葡萄膜炎科。眼底检查显示视盘肉芽肿，OCT 显示伴发高反射性，B 型超声显示高表面反射性伴中等内部反射性。胸部 CT 未见异常，但 PET 扫描显示纵隔和双侧肺门广泛摄取 FDG，符合结节病的诊断。
视神经头肉芽肿很少仅作为结节病的唯一临床征象出现。在这些情况下，可能需要额外的影像学检查来做出适当的诊断。
