Severe visual impairment due to an optic neuropathy and central retinal vein occlusion in a sarcoidosis patient

BACKGROUND: The ophthalmic manifestation of neurosarcoidosis is varied. The complication of optic neuropathy and central retinal vein occlusion (CRVO) is rare in sarcoidosis. CASE REPORT: The patient was a 55-year-old female with systemic sarcoidosis suffering from visual loss as hand motion in her left eye. A fundus examination showed severe optic disc head edema and hyperemia, and a central retinal vein occlusion phenotype including engorgement of all branches of the central retinal vein, dot, and flame-shaped hemorrhages. Brain magnetic resonance imaging (MRI) revealed irregular hypertrophy of the left retrobulbar optic nerve. She received several sets of pulse therapy with intravenous methylprednisolone. Although fundus findings of her left eye and the legion around the left retrobulbar optic nerve showed improvement, the final visual outcome was light perception due to optic nerve atrophy. CONCLUSIONS: Our findings suggest neurosarcoidosis of the unilateral retrobulbar optic nerve can cause compressive optic disc edema and resembles the central retinal vein occlusion (CRVO) phenotype.