Retinal nerve fiber layer thickness in optic tract syndrome.
BACKGROUND
Optic tract syndrome (OTS) is characterized by incongruous homonymous hemianopia and a perpendicular pattern of bilateral optic atrophy due to the optic tract lesion. However, loss of retinal nerve fiber layer thickness (RNFLT) associated with OTS has not been quantitatively assessed.


METHODS
A 20-year-old woman with blunt head trauma showed normal visual acuity, color vision, ocular motility, and intraocular pressure. Because of a relative afferent pupillary defect in her left eye and left-sided homonymous hemianopia, we suspected right-sided optic tract damage, although magnetic resonance imaging detected no intracranial lesion.


METHODS
Using optical coherence tomography (OCT), the RNFLT of this case was measured at 31 months after the trauma and compared with age-matched normal controls (n = 41). Nasal, temporal, superior, and inferior quadrant RNFLT was reduced by 22%, 21%, 5%, and 46% in the right eye and 76%, 64%, 25%, and 27% in the left eye, respectively. The reduction was > 3 x the standard deviation of the normal mean values in the nasal and temporal quadrants of the left eye and in the inferior quadrant of the right eye.


CONCLUSIONS
OCT can determine the RNFLT reduction corresponding to the characteristic patterns of optic atrophy of OTS.
Tatsumi
Yasuko
Y
Department of Organ Therapeutics, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Kanamori
Akiyasu
A
Kusuhara
Azusa
A
Nakanishi
Yoriko
Y
Kusuhara
Sentaro
S
Nakamura
Makoto
M
D000328:Adult; D003118:Color Perception; D005133:Eye Movements; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications; D006423:Hemianopsia / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure; D009412:Nerve Fibers / Q000473:pathology*; D009896:Optic Atrophy / Q000175:diagnosis* / Q000209:etiology; D011681:Pupil Disorders / Q000175:diagnosis* / Q000209:etiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D013577:Syndrome; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields; D014795:Visual Pathways / Q000473:pathology*