Retrograde degeneration of retinal ganglion cells in homonymous hemianopsia

Figures & data

Figure 1 Humphrey visual field for patient 1 showing gray scale image and total and pattern deviation demonstrating dense right homonymous hemianopsia.

Abbreviations: MD, Mean deviation; PSD, Pattern standard deviation.

Figure 2 (A) SD-OCT RNFL for patient 1 showing normal thickness without a relative difference in thickness between affected and unaffected fibers as well as an example of how the calculations were performed. (B) SD-OCT ganglion cell complex for patient 1 showing relative thinning in the nasal macula of the right eye and temporal macula of the left eye corresponding to the right hemianopsia.

Abbreviations: RNFL, retinal nerve fiber layer; SD-OCT, spectral-domain optical coherence tomography; IPL, inner plexiform layer; GCL, ganglion cell layer; ONH, optic nerve head; OD, right eye; OS, left eye; OU, both eyes.

Table 1 Patient demographics and clinical data

Patient Number	Age (years)	Sex	Side	Time from CVA to examination	HVF 30-2(MD, dB)		RNFL OD (μm)		RNFL OS (μm)		GCC (μm)
					A	U	A	U	A	U	A	U
1	57	M	R	Unknown	−30.4	−1.3	104	121	109	95	67.8	84.8
2	72	F	R	Unknown	−25.3	−1.5	52	80.3	86.7	54	59.5	74.8
3	65	M	L	3 months	−21.9	−1.8	67	81	86.7	69	75.2	74.8
4	60	M	R	Unknown	−29.4	−25.5	67	104	103	69	77	76.3
5	60	M	L	Unknown	−25.4	−8.1	73	106	98	73	74.7	79
6	58	M	R	Unknown	−30.4	−2.1	64	103	102.7	57	81	80
7	72	M	R	>14 months	−25.5	−2.4	57	71.7	62	57	63	72
8*	73	M	R	Unknown	−22.7	−17.6	‒	‒	‒	‒	67	68
9	70	M	L	Unknown	−27.3	−5.1	92.3	76	74	91	64	68
Mean	65.2				−26.5	−7.3					69.9	75.2
SD	6.61				6.10	8.46					7.98	6.68
P-value					<0.001						0.029

Notes:

* This patient’s right eye was excluded secondary to ophthalmic artery occlusion that led to diffuse RNFL and GCC thinning. The GCC measurements listed are for his left eye only; the affected visual field category is the average of the affected hemifield in the right and left eyes; there are two separate RNFL calculations, ie, nasal affected versus nasal unaffected: mean 74.1±19.49 μm versus 74.1±18.96 μm; P=0.99; and combined T/S/I affected versus unaffected: 90.63±18.01 μm versus 88.6±18.81 μm; the GCC reported in the affected column is the average of the affected hemiretina in the right and left eyes.

Abbreviations: CVA, cerebrovascular accident; GCC, ganglion cell complex; HVF, Humphrey visual field; A, affected; U, unaffected; MD, mean deviation; T/S/I, combined temporal, superior, inferior; SD, standard deviation; RNFL, retinal nerve fiber layer.

Figure 3 Axial T1-weighted magnetic resonance image of patient 1 demonstrating encephalomalacia of the left occipital lobe.