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Assessment of macular ganglion cell loss patterns in neurologic lesions that mimic glaucoma.

Shon K, Sung KR - Korean J Ophthalmol (2014)

Bottom Line: His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF).Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions.When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain optical coherence tomography in patients with neurologic lesions mimicking glaucoma.

Methods: We evaluated four patients with neurological lesions who showed characteristic patterns of RGC loss, as determined by ganglion cell thickness (GCT) mapping.

Results: Case 1 was a 30-year-old man who had been treated with glaucoma medication. A left homonymous vertical pattern of RGC loss was observed in his GCT map and a past brain magnetic resonance imaging (MRI) revealed a hemorrhagic lesion around the right optic radiation. Case 2 was a 72-year-old man with a pituitary adenoma who had a binasal vertical pattern of RGC loss that corresponded with bitemporal hemianopsia. Case 3 was a 77-year-old man treated for suspected glaucoma. His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRI revealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliable VF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern of RGC loss, which may have been related to a previous head trauma.

Conclusions: Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions. When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.

No MeSH data available.


Related in: MedlinePlus

The optic disc of a 30-year-old male showed increased cupping (A) and a spectral domain optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map revealed thinning in both eyes (B). Analysis of the patient's visual field revealed a mild left homonymous hemianopsia (C). His macular Ganglion cell thickness map showed left homonymous vertical pattern of loss (D). His brain magnetic resonance imaging showed a hemorrhagic lesion around the right optic radiation (E). OD = right eye; OS = left eye.
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Figure 2: The optic disc of a 30-year-old male showed increased cupping (A) and a spectral domain optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map revealed thinning in both eyes (B). Analysis of the patient's visual field revealed a mild left homonymous hemianopsia (C). His macular Ganglion cell thickness map showed left homonymous vertical pattern of loss (D). His brain magnetic resonance imaging showed a hemorrhagic lesion around the right optic radiation (E). OD = right eye; OS = left eye.

Mentions: A 30-year-old man was referred from his local eye clinic with suspected glaucoma. He had been treated with topical prostaglandin analogs for approximately one year. The patient began experiencing ocular complications from his glaucoma medications, so he was seeking a new treatment and was therefore referred to our clinic. His optic disc had increased cupping and the SD-OCT pRNFL thickness map revealed thinning in both of his eyes, most prominently in his superior and inferior quadrants with an average thickness of 73 and 74 µm in the right and left eyes, respectively (Fig. 2A and 2B). However, his VF was not compatible with a glaucomatous defect. Since his VF revealed the possibility of a left homonymous hemianopsia (Fig. 2C), and since he had suffered a head trauma several years previously, we reviewed his past MRI results. His macular GCT map showed a left homonymous vertical pattern of loss (Fig. 2D). His past brain MRI (coronal fast spin echo image) showed a hemorrhagic lesion around the right optic radiation (Fig. 2E).


Assessment of macular ganglion cell loss patterns in neurologic lesions that mimic glaucoma.

Shon K, Sung KR - Korean J Ophthalmol (2014)

The optic disc of a 30-year-old male showed increased cupping (A) and a spectral domain optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map revealed thinning in both eyes (B). Analysis of the patient's visual field revealed a mild left homonymous hemianopsia (C). His macular Ganglion cell thickness map showed left homonymous vertical pattern of loss (D). His brain magnetic resonance imaging showed a hemorrhagic lesion around the right optic radiation (E). OD = right eye; OS = left eye.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4120352&req=5

Figure 2: The optic disc of a 30-year-old male showed increased cupping (A) and a spectral domain optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map revealed thinning in both eyes (B). Analysis of the patient's visual field revealed a mild left homonymous hemianopsia (C). His macular Ganglion cell thickness map showed left homonymous vertical pattern of loss (D). His brain magnetic resonance imaging showed a hemorrhagic lesion around the right optic radiation (E). OD = right eye; OS = left eye.
Mentions: A 30-year-old man was referred from his local eye clinic with suspected glaucoma. He had been treated with topical prostaglandin analogs for approximately one year. The patient began experiencing ocular complications from his glaucoma medications, so he was seeking a new treatment and was therefore referred to our clinic. His optic disc had increased cupping and the SD-OCT pRNFL thickness map revealed thinning in both of his eyes, most prominently in his superior and inferior quadrants with an average thickness of 73 and 74 µm in the right and left eyes, respectively (Fig. 2A and 2B). However, his VF was not compatible with a glaucomatous defect. Since his VF revealed the possibility of a left homonymous hemianopsia (Fig. 2C), and since he had suffered a head trauma several years previously, we reviewed his past MRI results. His macular GCT map showed a left homonymous vertical pattern of loss (Fig. 2D). His past brain MRI (coronal fast spin echo image) showed a hemorrhagic lesion around the right optic radiation (Fig. 2E).

Bottom Line: His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF).Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions.When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain optical coherence tomography in patients with neurologic lesions mimicking glaucoma.

Methods: We evaluated four patients with neurological lesions who showed characteristic patterns of RGC loss, as determined by ganglion cell thickness (GCT) mapping.

Results: Case 1 was a 30-year-old man who had been treated with glaucoma medication. A left homonymous vertical pattern of RGC loss was observed in his GCT map and a past brain magnetic resonance imaging (MRI) revealed a hemorrhagic lesion around the right optic radiation. Case 2 was a 72-year-old man with a pituitary adenoma who had a binasal vertical pattern of RGC loss that corresponded with bitemporal hemianopsia. Case 3 was a 77-year-old man treated for suspected glaucoma. His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRI revealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliable VF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern of RGC loss, which may have been related to a previous head trauma.

Conclusions: Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions. When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.

No MeSH data available.


Related in: MedlinePlus