title: Photophobia associated with a demyelinating lesion of the retrochiasmal visual pathway.
abstract: OBJECTIVE
  To present two patients in whom photophobia was a predominant presenting symptom of retrochiasmal demyelination.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  Two women who experienced an acute onset of photophobia underwent neuroophthalmic examination and investigations at a single institution.
  
  
  RESULTS
  Examination revealed a homonymous visual field defect in both patients. Magnetic resonance imaging (MRI) demonstrated a hyperintense lesion in the area of the right posterior thalamus in one patient and enhancing lesions in the deep white matter of the temporal lobes bilaterally with contrast enhancement of the right optic tract in the second patient. Additional investigations, including lesion biopsy in the first patient, revealed demyelination as the most likely etiology. Improvement of photophobia, visual field defect, and radiographic abnormalities was documented over the next three to four months without accompanying treatment in both patients.
  
  
  CONCLUSIONS
  Central pathology, including demyelination of the retrochiasmal visual pathway, should be considered in patients who experience acute photophobia.
authors.affiliation: Department of Neuro-ophthalmology, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland. aki.kawasaki@ophtal.vd.ch
authors.forename: Aki
authors.initials: A
authors.lastname: Kawasaki
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Borruat
mesh_terms: D000328:Adult; D003711:Demyelinating Diseases / Q000150:complications*; D005260:Female; D006423:Hemianopsia / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009897:Optic Chiasm / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000150:complications*; D020795:Photophobia / Q000175:diagnosis / Q000209:etiology*; D014795:Visual Pathways / Q000473:pathology*