Assessment of Macular Ganglion Cell Loss Patterns in Neurologic Lesions That Mimic Glaucoma.
10.3341/kjo.2014.28.4.314
- Author:
Kilhwan SHON
1
;
Kyung Rim SUNG
Author Information
1. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sungeye@gmail.com
- Publication Type:Case Reports
- Keywords:
Ganglion cell thickness map;
Neurologic region;
Optical coherence tomography;
Visual fields
- MeSH:
Adult;
Aged;
Brain Injuries/diagnosis;
Cerebral Infarction/diagnosis;
Diagnosis, Differential;
Female;
Glaucoma/*diagnosis;
Hemianopsia/diagnosis;
Humans;
Magnetic Resonance Imaging;
Male;
Nerve Fibers/*pathology;
Nervous System Diseases/*diagnosis;
Pituitary Neoplasms/diagnosis;
Retinal Ganglion Cells/*pathology;
Retrospective Studies;
Tomography, Optical Coherence;
Tonometry, Ocular;
Visual Acuity;
Visual Field Tests;
Visual Fields
- From:Korean Journal of Ophthalmology
2014;28(4):314-322
- CountryRepublic of Korea
- Language:English
-
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.
