Retrograde degeneration of visual pathway: hemimacular thinning of retinal ganglion cell layer in progressive and active multiple sclerosis

Huang‐Link, Yumin; Al-Hawasi, Abbas; Eveman, Inger

doi:10.1007/s00415-014-7538-x

Cited by 10 publications

(12 citation statements)

References 11 publications

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“…Retinal nerve fibre patterns corroborate visual field data for lesions located before and including the optic chiasm but they are discordant between the two eyes and with visual field deficit, if the lesions are post‐chiasmal . Retrograde degeneration originating from post‐chiasmal lesions results in a homonymous pattern of visual field loss due to the partial decussation of optic nerve axons at the optic chiasm .…”

Section: Discussionmentioning

confidence: 53%

“…Based on the correlation of visual field and nerve fibre layer location, the most likely areas of nerve fibre layer thinning for each defect are indicated in the right panel. Predicted changes were compared to case studies reported in the literature (a: Huang‐Link, Al‐Hawasi and Eveman, b: Shon and Sung, c: Keller, Sanchez‐Dalmau and Villoslada, d: Meier and colleagues). Note that all defects are shown for lesions in the right hemisphere, while left hemisphere lesions will result in side‐inverted patterns.…”

Section: Discussionmentioning

confidence: 99%

“…Acute injury to the retinal ganglion cells might take four to six weeks for visible clinical manifestation of optic atrophy (pale optic disc) but can be prolonged with peripapillary retinal nerve fibre layer loss . Conditions caused by cortical insults resulting in retrograde degeneration may emulate retinal nerve fibre layer and visual field defects typically expected with slowly progressing chronic conditions . Even changes to the optic nerve head classically expected with glaucoma or arteritic anterior ischaemic optic neuropathy, such as cupping, have been associated with multiple other aetiologies .…”

mentioning

confidence: 99%

“…Furthermore, the retinotopic location of retinal nerve fibre axons entering the optic nerve head can cause early changes to be concealed from clinical observation, visual field testing or OCT peripapillary retinal nerve fibre layer profiles, despite being readily observed in macular ganglion cell measures. Therefore, a number of recent studies provided strong arguments to perform ganglion cell analysis in patients with suspected retrograde degeneration to take advantage of the concordance with visual field loss for diagnosis …”

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confidence: 99%

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Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series

Zangerl

Whatham

Kim

et al. 2017

Clinical and Experimental Optometry

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BackgroundAccurate diagnosis in patients presenting with lesions at various locations within the visual pathway is challenging. This study investigated functional and structural changes secondary to such lesions to identify patterns useful to guide early and effective management.MethodsOver 10,000 records from patients referred for optic nerve head assessment were reviewed and 31 patients with a final diagnosis of likely neuropathic lesions posterior to the eye were included in the current study. Fundus photographs, optic coherence tomography images and visual field tests were evaluated for changes with respect to retinal nerve fibre layer topography and prediction of structure‐function paradigms. Emerging clinical patterns were examined for their consistency with the likely anatomical origin of the underlying insult in the presence of varying diagnoses.ResultsData from patients with lesions along the visual system allowed identification of retinal nerve fibre layer asymmetry correlated with visual field defects and ganglion cell analysis. Bilateral discordance in retinal nerve fibre loss easily discernible from an altered pattern of the temporal‐superior‐nasal‐inferior‐temporal curve was characteristic for post‐chiasmal lesions. These sometimes‐subtle changes supported diagnosis in cases with multiple aetiologies or with ambiguous visual field analysis and/or ganglion cell loss.ConclusionIntricate knowledge of the retinal architecture and projections allows coherent predictions of functional and structural deficits following various lesions affecting the visual pathway. The integration of adjunct imaging and retinal nerve fibre layer thinning will assist clinicians to guide clinical investigations toward a likely diagnosis in the light of significant individual variations. The case series presented in this study aids in differential diagnosis of retrograde optic neuropathies by using retinal nerve fibre layer asymmetric patterns as an important clinical marker.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series

Zangerl

Whatham

Kim

et al. 2017

Clinical and Experimental Optometry

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“…While intracranial tumors cause the retrograde degeneration on the visual pathway, the pathologic changes starts from the distal axonal and progresses centripetally, which is also found in other central nervous system pathologies such as cerebral infarction, head trauma, multiple sclerosis [18][19][20]. That includes two conditions.…”

Section: Discussionmentioning

confidence: 99%

The different structure-function correlation as measured by OCT and Octopus perimetry cluster analysis in intracranial tumor and glaucoma patients

Li¹,

Qin²,

Cao³

et al. 2021

Preprint

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BackgroundTo explore the correlation of visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for the intracranial tumor and glaucoma patients. MethodsRetrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values measured with Octopus perimeter cluster analysis, and RNFL thickness and optic disk parameters measured with swept source OCT. The differences between VF and RNFL (included the data of optic disc) are calculated. The correlation between VF defect values and RNFL thickness are explored.Results43 eyes of 29 patients with the intracranial tumor and 39 eyes of 23 patients with the glaucoma are enrolled. Thickness of RNFL not only for the whole (360°), but also for the four quadrants are thinner in the glaucoma group than those of the intracranial tumor group (p<0.05). There is no significant difference of VF for those two groups. Stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the RNFL loss tending to the diagnosis of glaucoma, and the VF damage is inclined to the diagnosis of intracranial tumor.ConclusionsIntracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the antidiastole of intracranial tumor and glaucoma.

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Homonymous visual field defect and retinal thinning after occipital stroke

Rashid

Yang

et al. 2021

Brain and Behavior

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Introduction: Stroke is the most common cause of homonymous visual field defects (VFD). About half of the stroke patients recover from VFD. However, relationship between VFD and retinal changes remains elusive. Purpose:To investigate the association between occurrence of VFD, changes of macular ganglion cell and inner plexiform layer (GCIPL) and its axon retinal nerve fiber layer (RNFL) detected with optical coherence tomography (OCT). Patients and methods:The study consists of retrospective review of medical records and follow-up examinations. Patients with acute occipital stroke were registered. VFD was identified with confrontation and/or perimetry tests at the onset. At follow-up, the patients were examined with visual field tests and OCT measurements.Results: Thirty-six patients met the inclusion criteria. At onset, 26 patients (72%) had VFD. At follow-up >1 year after stroke, 13 patients (36%) had remaining VFD: 5 had homonymous hemianopia, 5 had homonymous quadrantanopia, and 3 had homonymous scotomas. Average thickness of GCIPL and RNFL were significantly reduced in each eye in patients with VFD compared to non-VFD (NVFD) (p < .01 for all comparisons). Thickness of superior and inferior RNFL quadrants was significantly reduced in VFD compared to NVFD (p < .01 for both). Among these 13 patients, 4 had characteristic homonymous quadrant-GCIPL thinning, 2 had characteristic homonymous hemi-GCIPL thinning, and 7 had diffuse GCIPL thinning. Conclusion:GCIPL and RNFL thinning were observed in the patients with VFD. GCIPL thinning appears in two forms: atypical diffuse thinning, or homonymous hemi-GCIPL thinning. Examining GCIPL and RNFL provides easy and reliable objective measures and is therefore proposed to be of predictive value on visual function.

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Retrograde degeneration of visual pathway: hemimacular thinning of retinal ganglion cell layer in progressive and active multiple sclerosis

Cited by 10 publications

References 11 publications

Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series

Reconciling visual field defects and retinal nerve fibre layer asymmetric patterns in retrograde degeneration: an extended case series

The different structure-function correlation as measured by OCT and Octopus perimetry cluster analysis in intracranial tumor and glaucoma patients

Homonymous visual field defect and retinal thinning after occipital stroke

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