Limits...
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

A brain magnetic resonance imaging of a 72-year-old man revealed a pituitary adenoma (A) displacing the pituitary stalk (arrow) and parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium-enhanced image of the coronal section. (B) His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (C). Analysis of his visual field revealed bitemporal hemianopsia (D) and a Ganglion cell thickness map showed a binasal vertical pattern of loss in the right eye, whereas the left eye showed a more generalized pattern of retinal ganglion cell loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4120352&req=5

Figure 3: A brain magnetic resonance imaging of a 72-year-old man revealed a pituitary adenoma (A) displacing the pituitary stalk (arrow) and parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium-enhanced image of the coronal section. (B) His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (C). Analysis of his visual field revealed bitemporal hemianopsia (D) and a Ganglion cell thickness map showed a binasal vertical pattern of loss in the right eye, whereas the left eye showed a more generalized pattern of retinal ganglion cell loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.

Mentions: A 72-year-old man was referred from the neurosurgery department for a preoperative ocular exam. He reported a reduction in his VF six months prior. His brain MRI (sagittal gadolinium enhanced image) revealed a pituitary adenoma (Fig. 3A) displacing the pituitary stalk (arrow) and the parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium enhanced image of the coronal section (Fig. 3B). His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (Fig. 3C).The patient's VF revealed a bitemporal hemianopsia (Fig. 3D) and an SD-OCT-based GCT map revealed a nasal vertical pattern of loss in the right eye, whereas the left eye had a more generalized pattern of loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (Fig. 3E).


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

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

A brain magnetic resonance imaging of a 72-year-old man revealed a pituitary adenoma (A) displacing the pituitary stalk (arrow) and parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium-enhanced image of the coronal section. (B) His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (C). Analysis of his visual field revealed bitemporal hemianopsia (D) and a Ganglion cell thickness map showed a binasal vertical pattern of loss in the right eye, whereas the left eye showed a more generalized pattern of retinal ganglion cell loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: A brain magnetic resonance imaging of a 72-year-old man revealed a pituitary adenoma (A) displacing the pituitary stalk (arrow) and parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium-enhanced image of the coronal section. (B) His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (C). Analysis of his visual field revealed bitemporal hemianopsia (D) and a Ganglion cell thickness map showed a binasal vertical pattern of loss in the right eye, whereas the left eye showed a more generalized pattern of retinal ganglion cell loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.
Mentions: A 72-year-old man was referred from the neurosurgery department for a preoperative ocular exam. He reported a reduction in his VF six months prior. His brain MRI (sagittal gadolinium enhanced image) revealed a pituitary adenoma (Fig. 3A) displacing the pituitary stalk (arrow) and the parenchyma to right side, and compression of the optic chiasm (arrowheads) on a T1-weighted gadolinium enhanced image of the coronal section (Fig. 3B). His left optic nerve looked more compressed than the right (arrows) on a T2-weighted coronal image (Fig. 3C).The patient's VF revealed a bitemporal hemianopsia (Fig. 3D) and an SD-OCT-based GCT map revealed a nasal vertical pattern of loss in the right eye, whereas the left eye had a more generalized pattern of loss, which was more severe at the nasal half and had a relatively preserved inferotemporal sector (Fig. 3E).

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