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Ahreum Chung, Young Jun Kim, Na Rae Kim; Vertical midline respecting ganglion cell layer defect in patients with space-occupying brain lesion. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5881.
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The axons of the retinal ganglion cells form the optic nerve, and the two optic nerves meet at the optic chiasm. The same axons continue through the optic tract, and travel to visual cortex. The purpose of these case series is to evaluate the pattern of macular ganglion cell defect in patients with space-occupying brain lesion and to elucidate the role of macular ganglion cell analysis (GCA) in patients with brain lesion.
A series of patients underwent spectral-domain optical coherent tomography (Cirrus OCT, Carl Zeiss Meditec, Dublin, CA), Humphrey visual field test, and brain MRI. Abnormal color patterns on the thickness and deviation map of macular ganglion cell analysis was evaluated and the defect pattern was compared with location of visual field defect.
Thirteen eyes in seven patients which showed vertical midline respecting ganglion cell-inner plexiform layer (GCIPL) defect on a map of macular GCA were enrolled. Five patients showed binasal GCIPL defects, which correspond to bitemporal hemianopia on visual field. They were diagnosed with pituitary adenoma in optic chiasm on brain MRI. One patient showed nasal GCIPL defect of right eye, which corresponded to temporal hemianopia of the same eye and was diagnosed as pituitary adenoma. Another patient showed nasal GCIPL defect in her right eye and temporal GCIPL defect in her left eye, which corresponds to left homonymous hemianopia. She was finally diagnosed with meningioma in right frontal lobe on brain MRI
Physicians should be cautious of the vertical midline respecting GCIPL defect pattern on macula. Brain imaging is mandatory in these patients. Macular GCA obtained by Cirrus OCT can be a complementary test to visual field assessment and brain MRI in the clinical evaluation of patients with brain lesion.
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