Sarcoidosis Presenting with Bilateral Optic Disc Edema as the Initial Presentation.

Sarcoidosis is a chronic, progressive, granulomatous inflammatory disease of unknown etiology that affects multiple organ systems. Granulomatous anterior uveitis is the most common eye finding, and optic nerve involvement at presentation is rarely seen. Here, we report a 43-year man referred to our clinic with eye pain, decreased vision, floaters and bilateral papillitis, vitritis and cystoid macular edema. The level of serum angiotensin-converting enzyme, thoracic computed tomography and transbronchial needle aspiration biopsy of lymph nodes were confirmatory for sarcoidosis. In this case, sarcoidosis initially presented with bilateral papillitis and vitritis without granulomatous uveitis, and successful results were obtained with methylprednisolone and immunosuppressive treatment without any relapse or systemic involvement of sarcoidosis. Sarcoidosis should be considered in patients presenting with optic nerve inflammation, even when granulomatous inflammation or vasculitis are not present, which are specific for ocular sarcoidosis. Key Words: Edema, Optic disc, Papillitis, Sarcoidosis.