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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

Analysis of a 77-year-old man showed increased cupping in his optic disc (A) and optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map is shown in (B). His Ganglion cell thickness map showed a right inferior quadratic pattern of loss (C) and analysis of his visual field showed a right superior homonymous quadranopsia (D). A brain magnetic resonance imaging revealed a left posterior cerebral artery territory infarct (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.
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Figure 4: Analysis of a 77-year-old man showed increased cupping in his optic disc (A) and optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map is shown in (B). His Ganglion cell thickness map showed a right inferior quadratic pattern of loss (C) and analysis of his visual field showed a right superior homonymous quadranopsia (D). A brain magnetic resonance imaging revealed a left posterior cerebral artery territory infarct (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.

Mentions: A 77-year-old man was referred from his local clinic for an ocular exam and brain imaging. He had been treated for cataracts, suspected glaucoma, and dry eye for several years. He recently complained of deterioration of his visual acuity, although the clinician at his local clinic could not detect any changes during ocular examination. His VF was tested at his local clinic, but the results were unreliable. His optic disc showed increased cupping and the OCT pRNFL thickness map showed thinning, most prominently in the inferior quadrant, with an average thickness of 69 and 77 µm in the right and left eyes, respectively (Fig. 4A and 4B). Examination of his VF was repeated at our clinic and revealed a right superior homonymous quadranopsia (Fig. 4C). His GCT deviation map showed a right inferior quadratic pattern of loss (Fig. 4D). His brain MRI (axial fluid-attenuated inversion recovery image) revealed a left posterior cerebral artery territory infarct (Fig. 4E).


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

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

Analysis of a 77-year-old man showed increased cupping in his optic disc (A) and optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map is shown in (B). His Ganglion cell thickness map showed a right inferior quadratic pattern of loss (C) and analysis of his visual field showed a right superior homonymous quadranopsia (D). A brain magnetic resonance imaging revealed a left posterior cerebral artery territory infarct (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 4: Analysis of a 77-year-old man showed increased cupping in his optic disc (A) and optical coherence tomography peripapillary retinal nerve fiber layer (RNFL) thickness map is shown in (B). His Ganglion cell thickness map showed a right inferior quadratic pattern of loss (C) and analysis of his visual field showed a right superior homonymous quadranopsia (D). A brain magnetic resonance imaging revealed a left posterior cerebral artery territory infarct (E). OD = right eye; OS = left eye; GCL = ganglion cell layer; IPL = inner plexiform layer.
Mentions: A 77-year-old man was referred from his local clinic for an ocular exam and brain imaging. He had been treated for cataracts, suspected glaucoma, and dry eye for several years. He recently complained of deterioration of his visual acuity, although the clinician at his local clinic could not detect any changes during ocular examination. His VF was tested at his local clinic, but the results were unreliable. His optic disc showed increased cupping and the OCT pRNFL thickness map showed thinning, most prominently in the inferior quadrant, with an average thickness of 69 and 77 µm in the right and left eyes, respectively (Fig. 4A and 4B). Examination of his VF was repeated at our clinic and revealed a right superior homonymous quadranopsia (Fig. 4C). His GCT deviation map showed a right inferior quadratic pattern of loss (Fig. 4D). His brain MRI (axial fluid-attenuated inversion recovery image) revealed a left posterior cerebral artery territory infarct (Fig. 4E).

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