Systemic megadose corticosteroid therapy for sarcoidosis with optic Disc granuloma

A 21-year-old male presented with visual field defect in his left eye since one week before. His corrected visual acuity was 1.5 right and 1.0 left. Both eyes showed cells in the aqueous, nodules in the chamber angle and vitreous opacity simulating string of pearls. Funduscopy of the left eye showed a large granuloma at the optic disc surrounded by serous retinal detachment. Systemic examinations including lymph node biopsy in the neck led to the diagnosis of sarcoidosis. He was then treated by intravenous methylprednisolone at the daily dosis of 200 mg and later by oral methylprednisolone 24 mg daily. The optic disc granuloma showed a complete remission after 2 months of treatment. This case illustrates the usefulness of systemic megadose corticosteroid therapy for sarcoidosis with optic disc granuloma.