Retrograde degeneration of retinal ganglion cells in homonymous hemianopsia

Abstract

BackgroundThe aim of this study was to demonstrate the relationship between topographic reduction in macular ganglion cell complex (GCC) thickness as detected with spectral-domain optical coherence tomography and visual field defects caused by ischemic occipital cortical injury.MethodsThis study was a retrospective review of all patients who presented to our eye institution between January 2012 and July 2014 with visual field defects secondary to ischemic cortical injury. The visual field defect pattern and mean deviation were analyzed. Retinal nerve fiber layer (RNFL) and macular GCC were both assessed with spectral-domain optical coherence tomography. Patients with any ocular pathology that could affect these measurements were excluded. The topographic relationship of visual field defect to reduction in GCC was specifically analyzed.ResultsNine patients met the inclusion criteria. Their average age was 65 (57–73) years; eight were men and six had right hemianopsias. The laterality of the visual field defect was used to assign an affected and unaffected side of analysis for RNFL and GCC layer thickness. A right hemianopsia meant that the nasal fibers of the right eye and temporal fibers of the left eye were assigned as the “affected side”, and the temporal fibers of the right eye and nasal fibers of the left eye were assigned as “unaffected”. There was no statistically significant difference between affected and unaffected RNFL. However, there was a significant difference in GCC layer reduction between the affected and unaffected sides (P=0.029).ConclusionThere is evidence of retrograde trans-synaptic retinal ganglion cell loss in patients with homonymous hemianopsias from cortical visual impairment. This relationship is reflected in thinning of the GCC and maintains the topographic relationship of the visual field defect.

Alzheimer’s disease: A review of its visual system neuropathology. Optical coherence tomography—a potential role as a study tool in vivo

“…Evidence from OCT studies also supports a role for TRD in disorders of the posterior visual pathway [34,35,67,68] with visual field defects in these disorders correlating best with macular GCL thickness than with RNFL thickness [67,68]. Likewise, OCT findings in AD suggest the contribution of TRD in the pathophysiology of visual changes.…”

Macular Ganglion Cell Layer and Peripapillary Retinal Nerve Fibre Layer Thickness in Patients with Unilateral Posterior Cerebral Artery Ischaemic Lesion: An Optical Coherence Tomography Study

“…In a subsequent study by this group, 5 there was a detectable thinning of RNFL after 100 days of the insult, with greater loss occurring in the first 1-2 years. Only case reports 3,24 and small-sample studies [25][26][27] have reported a thinning of the RGC layer in the hemiretina of patients with either mixed posterior lesions or isolated PCA ischaemic events. To our knowledge, this is the first case-control study with patients with unilateral PCA ischaemic lesions.…”

Progression of transsynaptic retinal degeneration with spectral-domain optical coherence tomography

“…This is presumed to represent transsynaptic retinal degeneration and has been reported using spectral-domain optical coherence tomography (SD-OCT) of the macula, 1 ganglion cell complex (GCC), 2 or retinal nerve fiber layer (RNFL). 3 The retinal changes may not occur, or may occur after a variable delay following the neurologic event.…”