Assessment of Macular Ganglion Cell Loss Patterns in Neurologic Lesions That Mimic Glaucoma
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Purpose: To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain opticalcoherence 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 homonymousvertical 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 pituitaryadenoma 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 quadraticpattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRIrevealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliableVF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern ofRGC 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 ofRGC-related diseases, including glaucoma and neurologic lesions. When a patient’s VF is unavailable, thismethod may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-relatedstructural changes.
Abstract
Purpose: To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain opticalcoherence 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 homonymousvertical 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 pituitaryadenoma 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 quadraticpattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRIrevealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliableVF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern ofRGC 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 ofRGC-related diseases, including glaucoma and neurologic lesions. When a patient’s VF is unavailable, thismethod may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-relatedstructural changes.
참고문헌 (17)
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