Optic Nerve Manifestations of Sarcoidosis

THE FREQUENCY with which the nervous system is involved by sarcoidosis was first emphasized by Colover in 1948.1Recent studies disclose that the nervous system may be implicated in up to 16% of all cases of sarcoidosis.2Ocular involvement is more common, being encountered in about 30% of all cases.3-9The fundus is involved in about 15% of cases of sarcoidosis6and of these, in one third of the cases the optic disc is involved.5Thus about 5% of cases of sarcoidosis will have demonstrable changes of the optic papilla. Patients with funduscopic manifestations of sarcoidosis not uncommonly have clinical evidence of nervous system involvement. Gould and Hauffman found that of 40 patients with abnormalities of the fundus due to sarcoid, one third had central nervous system (CNS) manifestations.7 This paper describes the clinical features in three patients with systemic sarcoidosis who had both