Transition from macular splitting to macular sparing in right homonymous hemianopia complicating a left occipitoparietal hemorrhage

Abstract

The authors describe a 62-year-old patient who developed a complete right homonymous hemianopia due to an occipitoparietal hemorrhage. Within several weeks the macular splitting pattern of hemianopia evolved to macular sparing as vision in the central 5 to 10 degrees of the hemianopic field recovered. This correlated with absorption of the hemorrhage and secondary edema. In the authors′ patient visual improvement was most likely due to functional recovery of the macular representation area in the posterior occipital lobe. Because of the extent of visual field recovery it is unlikely that bilateral projections of foveal ganglion cells were responsible for the observed pattern of macular sparing in this patient.

Key Words:

• Macular splitting
• macular sparing
• homonymous hemianopia
• cerebral hemorrhage