Journal List > J Korean Ophthalmol Soc > v.60(1) > 1111842

Kim, Park, and Jung: Ganglion Cell Analysis in an Optic Tract Syndrome Patient Previously Diagnosed with Glaucoma

Abstract

Purpose

To report the results of ganglion cell analysis in a patient with optic tract syndrome who was previously diagnosed with glaucoma.

Case summary

A 32-year-old male, who had been diagnosed with glaucoma 12 years ago, but had not visited an ophthalmology clinic since then, came to our clinic for evaluation of his glaucoma. Both eyes showed an increased cup-to-disc ratio and temporal pallor of the disc. Retinal nerve fiber layer (RNFL) optical coherence tomography showed thinning of the superior, inferior, and temporal peripapillary RNFL in both eyes. On ganglion cell analysis (GCA), ganglion cell layer thinning in the nasal region of the right eye and in the temporal region of the left eye was observed. The visual field test showed right incongruous homonymous hemianopsia. After the atrophic change of the left optic tract was confirmed by orbit magnetic resonance imaging, he was diagnosed with left optic tract syndrome.

Conclusions

We report the results of GCA in a case of optic tract syndrome, previously diagnosed as glaucoma. GCA can be useful when diagnosing optic tract syndrome.

Figures and Tables

Figure 1

Results of fundus photography. Both optic discs showed increased cup-disc ratio and mild temporal pallor.

jkos-60-91-g001
Figure 2

Results of RNFL optical coherence tomography (OCT). RNFL OCT showed thinning of superior, inferior and temporal RNFL of both eyes. RNFL = retinal nerve fiber layer; N = nasal; T = temporal.

jkos-60-91-g002
Figure 3

Results of ganglion cell analysis. On ganglion cell analysis, thinning of the ganglion cell layer was prominent in the nasal region of the right eye and the temporal region of the left eye respecting the vertical meridian.

jkos-60-91-g003
Figure 4

Results of visual field analysis. Right incongruous homonymous hemianopsia was shown in Humphrey visual field test 24-2, which is in accordance with the retinal nerve fiber layer and ganglion cell analysis test results.

jkos-60-91-g004
Figure 5

Mild atrophic change of the left optic tract was observed (arrow) in T2-weighted orbit magnetic resonance imaging.

jkos-60-91-g005

Notes

Conflicts of Interest The authors have no conflicts to disclose.

References

1. el Gammal T, Brooks B, Harbour R, et al. MR of uncommon congenital and vascular lesions of the intracranial visual pathways. Neuroradiology. 1990; 32:488–491.
crossref pmid
2. Margo CE, Hamed LM, McCarty J. Congenital optic tract syndrome. Arch Ophthalmol. 1991; 109:1120–1122.
crossref pmid
3. Murphy MA, Grosof DH, Hart WM Jr. Congenital optic tract syndrome: magnetic resonance imaging and scanning laser ophthalmoscopy findings. J Neuroophthalmol. 1997; 17:226–230.
4. Lee EJ, Kim JH, Hwang JM. Congenital optic tract syndrome misdiagnosed with normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2016; 254:2481–2483.
crossref pmid
5. Kim JY, Lee HJ, Kwag JY, Lee YH. The optical coherence tomography findings of optic tract syndrome. J Korean Ophthalmol Soc. 2013; 54:1144–1148.
crossref
6. Shin HY, Park HY, Choi JA, Park CK. Macular ganglion cell-inner plexiform layer thinning in patients with visual field defect that respects the vertical meridian. Graefes Arch Clin Exp Ophthalmol. 2014; 252:1501–1507.
crossref pmid
7. Savino PJ, Paris M, Schatz NJ, et al. Optic tract syndrome. A review of 21 patients. Arch Ophthalmol. 1978; 96:656–663.
pmid
8. Unsöld R, Hoyt WF. Band atrophy of the optic nerve. The histology of temporal hemianopsia. Arch Ophthalmol. 1980; 98:1637–1638.
pmid
9. Newman SA, Miller NR. Optic tract syndrome. Neuro-ophthalmologic considerations. Arch Ophthalmol. 1983; 101:1241–1250.
pmid
10. Kupfer C, Chumbley L, Downer JC. Quantitative histology of optic nerve, optic tract and lateral geniculate nucleus of man. J Anat. 1967; 101(Pt 3):393–401.
pmid pmc
11. Hsu CY, Lai YH, Hsu SY, et al. Optical coherence tomography (OCT) findings in patients with optic tract syndrome. Taiwan J Ophthalmol. 2011; 1:16–20.
crossref
TOOLS
Similar articles