title: Assessment of macular ganglion cell loss patterns in neurologic lesions that mimic glaucoma.
abstract: OBJECTIVE
  To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain optical coherence tomography in patients with neurologic lesions mimicking glaucoma.
  
  
  METHODS
  We evaluated four patients with neurological lesions who showed characteristic patterns of RGC loss, as determined by ganglion cell thickness (GCT) mapping.
  
  
  RESULTS
  Case 1 was a 30-year-old man who had been treated with glaucoma medication. A left homonymous vertical pattern of RGC loss was observed in his GCT map and a past brain magnetic resonance imaging (MRI) revealed a hemorrhagic lesion around the right optic radiation. Case 2 was a 72-year-old man with a pituitary adenoma who had a binasal vertical pattern of RGC loss that corresponded with bitemporal hemianopsia. Case 3 was a 77-year-old man treated for suspected glaucoma. His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRI revealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliable VF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern of RGC loss, which may have been related to a previous head trauma.
  
  
  CONCLUSIONS
  Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions. When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kilhwan
authors.initials: K
authors.lastname: Shon
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyung Rim
authors.initials: KR
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000175:diagnosis; D002544:Cerebral Infarction / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006423:Hemianopsia / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009422:Nervous System Diseases / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields
keywords: Ganglion cell thickness map; Neurologic region; Optical coherence tomography; Visual fields