title: Corresponding Ganglion Cell Atrophy in Patients With Postgeniculate Homonymous Visual Field Loss.
abstract: BACKGROUND
  The goal of our study was to look for the presence of homonymous ganglion cell layer-inner plexiform layer complex (GCL-IPL) thinning using spectral-domain optical coherence tomography (SD-OCT) in patients with a history of adult-onset injury to the postgeniculate pathways with rigorous radiological exclusion of geniculate and pregeniculate pathology.
  
  
  METHODS
  We performed a retrospective review of twenty-two patients (ages 24-75 y, 6 men, 16 women) with homonymous visual field (VF) defects secondary to postgeniculate injury examining the GCL-IPL with SD-OCT. An additional fifteen patients (ages 28-85 y, 5 men, 10 women) with no visual pathway pathology served as controls. Using segmentation analysis software applied to the macular scan, a normalized asymmetry score was calculated for each eye comparing GCL-IPL thickness ipsilateral vs contralateral to the patient's brain lesions.
  
  
  RESULTS
  We found that 15 of the twenty-two subjects had a relative thinning of the GCL-IPL ipsilateral to the postgeniculate lesion in both eyes (represented by a positive normalized asymmetry score in both eyes), whereas a similar pattern of right/left asymmetry was found in 4 controls (P = 0.0498). The magnitude of asymmetry was much greater in subjects compared with controls (P = 0.0004). There was no association between the degree of GCL-IPL thinning and the mean deviation on automated VF testing. A moderate correlation (R = 0.782, P = 0.004) between the magnitude of thinning and latency from onset of retrogeniculate injury was observed only after excluding patients beyond a cutoff point of 150 months.
  
  
  CONCLUSIONS
  This data provides compelling new evidence of retrograde transsynaptic degeneration causing retinal ganglion cell loss after postgeniculate visual pathway injury.
authors.affiliation: Departments of Ophthalmology (JM, CO, MD), Radiology (AJT), and Neurology (MD), Weill Cornell Medical College, New York, New York.
authors.forename: Jamie R
authors.initials: JR
authors.lastname: Mitchell
authors.forename: Cristiano
authors.initials: C
authors.lastname: Oliveira
authors.forename: Apostolos J
authors.initials: AJ
authors.lastname: Tsiouris
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Dinkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000209:etiology / Q000473:pathology; D005260:Female; D006423:Hemianopsia / Q000150:complications / Q000473:pathology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014795:Visual Pathways / Q000473:pathology; D055815:Young Adult