Optic neuropathy in refractory neurosarcoidosis treated with TNF-alpha antagonist.

Methods: To report a rare case of optic neuropathy in refractory neurosarcoidosis treated with tumour necrosis factor-alpha antagonist (infliximab) perfusion. A 41-year-old man with diabetes presented with an abrupt, painless, unilateral visual loss. Thoracic computed tomography disclosed mediastinal lymphadenopathy, and evidence from histopathology confirmed sarcoidosis.

Conclusions: Corticosteroids alone and with immunosuppressive agents failed to suppress the active disease. Alternative therapy of infliximab perfusions resulted in disease remission and relative visual improvement, and this treatment may warrant further clinical studies.