Homonymous Ganglion Cell Layer Thinning After Isolated Occipital Lesion

Abstract

A 48-year-old man was examined 24 months after medial and surgical treatment of an isolated well-circumscribed right occipital lobe abscess. An asymptomatic residual left homonymous inferior scotoma was present. Fundus examination revealed temporal pallor of both optic discs, and optical coherence tomography (OCT) revealed mild temporal loss of retinal nerve fiber layer in both eyes. No relative afferent pupillary defect was present. Assessment of the retinal ganglion cell layer demonstrated homonymous thinning in a pattern corresponding to the homonymous visual field loss. There were no abnormalities of the lateral geniculate nuclei or optic tracts on review of the initial brain computed tomography and follow-up magnetic resonance imaging. We believe our patient showed evidence of transsynaptic retrograde degeneration after an isolated right occipital lobe lesion, and the homonymous neuronal loss was detected on OCT by assessing the retinal ganglion cell layer.

Alterations of optic tract and retinal structure in patients after thalamic stroke

“…Previous reports showed that transsynaptic retrograde neurodegeneration (TRD) after post-thalamic visual area (occipital lobe) stroke was high after the first few years and fairly stable over the years (Cowey et al, 2011;Jindahra et al, 2012;Meier et al, 2015;Schneider et al, 2019). In our previous report (Ye et al, 2022), thalamic infarction patients with a duration of more than 6 months also showed a thinner retinal structure compared to patients with a duration of fewer than 6 months.…”

Evaluation of Significance Maps and the Analysis of the Longitudinal Time Course of the Macular Ganglion Cell Complex Thicknesses in Acquired Occipital Homonymous Hemianopia Using Spectral-domain Optical Coherence Tomography

“…OCT studies of acquired occipital lobe lesions in humans have demonstrated circumpapillary retinal nerve fibre layer (cpRNFL) thinning with the use of TD-OCT, 4-6 and SD-OCT. [7][8][9]17 In the SD-OCT studies, inner retinal thinning was observed in both the peripapillary and macular areas, in accordance with the patients' hemianopic visual field defects. [9][10][11][12][13][14][15][16]18,23 GCC thinning has been demonstrated in the hemiretinae corresponding to the affected hemifields. Furthermore, macular measurements showed localised defects of RGCs more clearly than peripapillary measurements.…”

“…In these SD-OCT studies, inner retinal thinning was observed in both the peripapillary and macular areas, in accordance with the patients' hemianopic visual field defects. [9][10][11][12][13][14][15][16][17][18] More recently, sweptsource OCT (SS-OCT), which permits even faster scanning, has been used to study inner retinal thinning in homonymous hemianopia. 19 Recent advancements in spectral-domain optical coherence tomography (SD-OCT) has enabled the assessment of the RGC layer and the ganglion cell complex (GCC), which includes the retinal layers from the internal limiting membrane to the inner plexiform layer.…”

Direct and transsynaptic retrograde degeneration and optic nerve head microvascular changes in patients with hemianopia

“…TRD in human visual system has been demonstrated in many studies. 2,3,6,[12][13][14][15][16][17][18][19] Guedes et al reported a case with RNF loss (1) of the patient with postgeniculate lesion had decreased vessel density (1a, 1b), RNFL thickness (1c), and GCC thickness (1d) at peripapillary area. Contralateral eye (2) revealed decreased vessel density (2a, 2b), RNFL thickness (2c), and GCC thickness (2d), especially at nasal sectors.…”

“…5 Previous studies in the literature demonstrated that abnormalities of macula GCC occurred earlier than peripapillary RNFL thickness. 15,[22][23][24] Moreover, the interpretation of GCC thinning and related visual field loss is easier. It has a simple mirror-image relationship with the visual field, in contrast to the complex relationship between RNFL bundles and visual field sectors that have been mapped previously.…”