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Case of unilateral peripheral cone dysfunction.

Mochizuki Y, Shinoda K, Matsumoto CS, Klose G, Watanabe E, Seki K, Kimura I, Mizota A - Case Rep Ophthalmol (2012)

Bottom Line: A severe constriction of the visual fields was found in both eyes but more in the right eye.The photopic full-field electroretinograms (ERGs) were reduced in the right eye but normal in the left eye.Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Tokyo, Japan.

ABSTRACT

Purpose: Peripheral cone dystrophy is a subgroup of cone dystrophy, and only 4 cases have been reported. We present a patient with unilateral peripheral cone dysfunction and report the functional changes determined by electrophysiological tests and ultrastructural changes determined by spectral domain optical coherence tomography (SD-OCT).

Case: A 34-year-old woman complained of blurred vision in both eyes. Our examination showed that her visual acuity was 0.05 OD and 0.2 OS. A relative afferent pupillary defect was present in her right eye. The results of slit-lamp examination, ophthalmoscopy, and fluorescein angiography were normal except for pallor of the right optic disc. SD-OCT showed a diffuse thinning of the retina in the posterior pole of the right eye. A severe constriction of the visual fields was found in both eyes but more in the right eye. The photopic full-field electroretinograms (ERGs) were reduced in the right eye but normal in the left eye. The multifocal ERGs were severely reduced throughout the visual field except in the central area of the right eye. The multifocal ERGs from the left eye were normal. The pattern visual evoked responses were within the normal range in both eyes. She had a 5-year history of sniffing paint thinner.

Results: Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye. The pathophysiological mechanism and the relationship with thinner sniffing were not determined.

Conclusions: Our findings indicate that peripheral cone dysfunction can occur unilaterally. Electrophysiology and SD-OCT are valuable tests to perform to determine the pathogenesis of unusual ocular findings objectively.

No MeSH data available.


Related in: MedlinePlus

Fundus photographs, fluorescein angiograms, visual fields, and optical coherence tomographic (OCT) images from our patient with unilateral peripheral cone dystrophy. a–d Fundus photographs and fluorescein angiograms showing no abnormal findings. e–h OCT images from a 9-mm horizontal scan of the right (e) and left (f) eyes and vertical scan in the right (g) and left (h) eyes. Note that the outer nuclear layer is thinner in the right eye than that in the left eye in large areas of the retinal except the fovea (inset). i–m Goldmann visual fields showing bilateral constriction of the visual fields in both eyes but more severe in the right eye.
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Figure 1: Fundus photographs, fluorescein angiograms, visual fields, and optical coherence tomographic (OCT) images from our patient with unilateral peripheral cone dystrophy. a–d Fundus photographs and fluorescein angiograms showing no abnormal findings. e–h OCT images from a 9-mm horizontal scan of the right (e) and left (f) eyes and vertical scan in the right (g) and left (h) eyes. Note that the outer nuclear layer is thinner in the right eye than that in the left eye in large areas of the retinal except the fovea (inset). i–m Goldmann visual fields showing bilateral constriction of the visual fields in both eyes but more severe in the right eye.

Mentions: A 34-year-old Japanese woman complained of a gradually decrease of her vision in both eyes. She visited a neighborhood eye clinic on December 2008, and the examination showed that her best-corrected decimal visual acuity (BCVA) was 0.3 OD and 0.5 OS. A diagnosis was not made, and she was not treated. Three months later she was referred to our clinic. She reported that she had noticed that her right visual field had been constricted for 10 years. She did not complain of photopsia, photophobia, night blindness, or color vision disturbances. She had a history of paint thinner sniffing of more than 5 years. Our examination showed that her BCVA was 0.05 OD and 0.2 OS. The results of slit-lamp biomicroscopy, ophthalmoscopy, and fluorescein angiography were normal except for right optic disc pallor (fig. 1). Goldman and Humphrey visual field tests showed a concentric constriction of the visual fields in both eyes but more severe in the right eye (fig. 1). A relative afferent pupillary defect was present in the right eye. Brain magnetic resonance imaging showed no abnormalities.


Case of unilateral peripheral cone dysfunction.

Mochizuki Y, Shinoda K, Matsumoto CS, Klose G, Watanabe E, Seki K, Kimura I, Mizota A - Case Rep Ophthalmol (2012)

Fundus photographs, fluorescein angiograms, visual fields, and optical coherence tomographic (OCT) images from our patient with unilateral peripheral cone dystrophy. a–d Fundus photographs and fluorescein angiograms showing no abnormal findings. e–h OCT images from a 9-mm horizontal scan of the right (e) and left (f) eyes and vertical scan in the right (g) and left (h) eyes. Note that the outer nuclear layer is thinner in the right eye than that in the left eye in large areas of the retinal except the fovea (inset). i–m Goldmann visual fields showing bilateral constriction of the visual fields in both eyes but more severe in the right eye.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369245&req=5

Figure 1: Fundus photographs, fluorescein angiograms, visual fields, and optical coherence tomographic (OCT) images from our patient with unilateral peripheral cone dystrophy. a–d Fundus photographs and fluorescein angiograms showing no abnormal findings. e–h OCT images from a 9-mm horizontal scan of the right (e) and left (f) eyes and vertical scan in the right (g) and left (h) eyes. Note that the outer nuclear layer is thinner in the right eye than that in the left eye in large areas of the retinal except the fovea (inset). i–m Goldmann visual fields showing bilateral constriction of the visual fields in both eyes but more severe in the right eye.
Mentions: A 34-year-old Japanese woman complained of a gradually decrease of her vision in both eyes. She visited a neighborhood eye clinic on December 2008, and the examination showed that her best-corrected decimal visual acuity (BCVA) was 0.3 OD and 0.5 OS. A diagnosis was not made, and she was not treated. Three months later she was referred to our clinic. She reported that she had noticed that her right visual field had been constricted for 10 years. She did not complain of photopsia, photophobia, night blindness, or color vision disturbances. She had a history of paint thinner sniffing of more than 5 years. Our examination showed that her BCVA was 0.05 OD and 0.2 OS. The results of slit-lamp biomicroscopy, ophthalmoscopy, and fluorescein angiography were normal except for right optic disc pallor (fig. 1). Goldman and Humphrey visual field tests showed a concentric constriction of the visual fields in both eyes but more severe in the right eye (fig. 1). A relative afferent pupillary defect was present in the right eye. Brain magnetic resonance imaging showed no abnormalities.

Bottom Line: A severe constriction of the visual fields was found in both eyes but more in the right eye.The photopic full-field electroretinograms (ERGs) were reduced in the right eye but normal in the left eye.Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Tokyo, Japan.

ABSTRACT

Purpose: Peripheral cone dystrophy is a subgroup of cone dystrophy, and only 4 cases have been reported. We present a patient with unilateral peripheral cone dysfunction and report the functional changes determined by electrophysiological tests and ultrastructural changes determined by spectral domain optical coherence tomography (SD-OCT).

Case: A 34-year-old woman complained of blurred vision in both eyes. Our examination showed that her visual acuity was 0.05 OD and 0.2 OS. A relative afferent pupillary defect was present in her right eye. The results of slit-lamp examination, ophthalmoscopy, and fluorescein angiography were normal except for pallor of the right optic disc. SD-OCT showed a diffuse thinning of the retina in the posterior pole of the right eye. A severe constriction of the visual fields was found in both eyes but more in the right eye. The photopic full-field electroretinograms (ERGs) were reduced in the right eye but normal in the left eye. The multifocal ERGs were severely reduced throughout the visual field except in the central area of the right eye. The multifocal ERGs from the left eye were normal. The pattern visual evoked responses were within the normal range in both eyes. She had a 5-year history of sniffing paint thinner.

Results: Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye. The pathophysiological mechanism and the relationship with thinner sniffing were not determined.

Conclusions: Our findings indicate that peripheral cone dysfunction can occur unilaterally. Electrophysiology and SD-OCT are valuable tests to perform to determine the pathogenesis of unusual ocular findings objectively.

No MeSH data available.


Related in: MedlinePlus