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

Figures & data

Table 1. Classification of 31 clinical cases with retrograde degeneration

Location	Pathology	Number of cases
Pre‐chiasmalunilateral opticneuritis/atrophy	Multiple sclerosis/Divic's diseaseTraumaUnknown	435
Chiasmal	Confirmed pituitary tumourUnconfirmed	13
Post‐chiasmalretrogradedegeneration	Cardiovascular accident^† Trauma Surgery Viral Unknown^†	63114

† The retinal nerve fibre layer/ganglion cell thickness was above average in five patients (four cardiovascular accident patients and one with unknown pathology). While these patients had described asymmetry, the absolute measurements remained within normal limits.

Table 2. Patient characteristics

Patient number	Age	Sex	VA		SE		Relevant symptoms/history	Lesion location	Pathology
			RE	LE	RE	LE
1	38	M	6/7.6	6/6	−0.50	−0.63	Meningitis at 2 weeks old	Left calcarine fissure	Inflammation
2	57	M	6/6^+2	6/4.8	−0.38	−0.25	Surgical removal of an aneurysm at 39 years	Left optic tract	Aneurysm/surgery
3	51	M	6/6^−1	6/6	+0.25	+0.13	Fractured right eye socket at 41 years and motorcycle accidents with head injuries	Right post‐chiasm	Head trauma
4	55	M	6/6	6/6	+0.00	+0.00	Previous chemical trauma, nothing else, suspected glaucoma	Optic tract	Unknown
5	69	M	6/6	6/4.8	+2.75	+2.75	Transient ischemic attack at 60 years	Post‐chiasm	Mini‐stroke
6	24	M	6/6^+2	6/6^+2	+0.00	+0.25	Unremarkable, LE pigmented lesion	Right post‐chiasmal, most likely occipital lobe	Unknown
7	23	M	6/6	6/6	+0.63	+0.63	Head injury at 2 years of age, first imaged at 19, no change since	Left post‐chiasmal, most likely occipital lobe	Unknown
8	60	F	6/4.8^−1	6/4.8	+0.63	+0.25	Diagnosed with multiple sclerosis at 33 years, left optic neuritis at 43 years	Left optic nerve	Optic neuritis LE
9	84	M	6/120	6/15	−1.50	−2.00	Pituitary tumour diagnosed at 74 years	Optic chiasm	Pituitary tumour
10	54	M	6/6^−2	6/6	−0.75	−0.50	Blurry vision, referred for macula and glaucoma suite	Likely left optic chiasm	Unknown
11	51	M	6/12	6/75	−0.50	−1.00	LE poor vision for 3 years, resident ophthalmologist and optometrist consulted in last 6 months with no results	Likely optic chiasm	Unknown
12	69	M	6/5	6/5	+0.25	−1.25	Transient double vision 6 months ago followed by partial visual loss	Left occipital lobe and both optic nerve heads	Glaucoma; CVA
13	75	F	6/6	6/6	−0.63	−1.50	Electrical injury at 66 years; Cardiovascular accident at 70 years	Likely right parietal lobe	Electrical injury; CVA
14	77	M	6/9	6/9	+1.00	+0.75	Cardiovascular accident at 62 years	Likely right temporal lobe	CVA

CVA: cardiovascular accident, SE: spherical equivalent, VA: visual acuity.

Patient 1: Features are shown in Figures 1 and 2.

Patients 2 to 7: Features are shown in Figure 3.

Patients 8 to 11: Features are shown in Figure 4.

Patients 12 to 14: Features are shown in Figure 5.

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