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Visual Fields and Ocular Coherence Tomography Predict Location of the Intracranial Lesion

Ocular coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GC-IPL) demonstrated generalized thinning in RE and nasal loss in LE, consistent with a junctional scotoma (Figure 1B). Junctional scotoma results from the lesion affecting pre-chiasmatic optic nerve, thus producing genera...

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Bibliographic Details
Published in:Canadian journal of neurological sciences 2023-07, Vol.50 (4), p.626-627
Main Authors: Popovic, Marko M., Margolin, Edward
Format: Article
Language:English
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Summary:Ocular coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GC-IPL) demonstrated generalized thinning in RE and nasal loss in LE, consistent with a junctional scotoma (Figure 1B). Junctional scotoma results from the lesion affecting pre-chiasmatic optic nerve, thus producing generalized depression on ipsilateral VF, and crossing nasal fibers from the contralateral eye, which results in temporal defect on VF in the fellow eye and correspondingly nasal thinning on GC-IPL. Peripapillary OCT demonstrated hourglass atrophy in the RE and bowtie atrophy in the LE, suggesting a lesion in the right optic tract (Figure 1C): optic tract contains axons from the temporal retinal from the ipsilateral eye, which enter optic nerve superiorly and inferiorly resulting in superior and inferior thinning on peripapillary OCT in ipsilateral eye, and crossed axons representing nasal retina from the contralateral eye, which enter optic nerves on its temporal and nasal sides, representing the so-called band atrophy.1 Figure 1: (A) 24-2 Humphrey visual field demonstrating central scotoma in right eye and left homonymous defect in left eye.
ISSN:0317-1671
2057-0155
DOI:10.1017/cjn.2022.263