Superior oblique paresis with contralateral relative afferent pupillary defect.
BACKGROUND
The purpose of this study is to report a case of superior oblique paresis and contralateral relative afferent pupillary defect (RAPD) with normal vision in a patient with brainstem astrocytoma.


METHODS
We correlated the patient's clinical findings with anatomical substrates on magnetic resonance imaging (MRI) findings.


RESULTS
The patient had right-sided superior oblique paresis. There was a left-sided RAPD, although visual acuities and visual fields were normal in both eyes. T1-weighted, gadolinium-enhanced MRI demonstrated a hyperintense area in the right dorsal midbrain.


CONCLUSIONS
It is suggested that the lesion damaged both the pretectal afferent pupillary pathway and fascicles of the trochlear nerve, causing a unique combination of neuro-ophthalmologic findings.
Taguchi
H
H
Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan.
Kashii
S
S
Kikuchi
M
M
Yasuyoshi
H
H
Honda
Y
Y
D000328:Adult; D001254:Astrocytoma / Q000150:complications* / Q000175:diagnosis; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology*; D020432:Trochlear Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields