Purpose: To report abnormalities of retinal nerve fiber layer (RNFL) thickness using Stratus -optical coherence tomography (OCT) in two patients with optic tract lesions. Methods: Two patients with long standing homonymous hemianopia from optic tract lesions were submitted to a complete neuro-ophthalmic evaluation and to Stratusoptical coherence tomography examination. Results: Both patients revealed diffuse loss of the RNFL at Stratus -OCT in both eyes. In the eyes with the temporal hemianopia, RFNL loss was diffuse but predominantly in the nasal and temporal areas of the optic disc, the classic pattern of band atrophy of the optic nerve. In the eyes with nasal hemianopia RNFL loss could be documented in the superior and inferior quadrants of the optic disc. RNFL loss correlated well with visual field loss and the expected pattern of RNFL loss in optic tract lesions. Conclusion : Stratus-Optical coherence tomography can provide useful information in the diagnosis of optic tract lesions by identifying the characteristic pattern of RNFL loss that occurs in both eyes in this condition.
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