J Korean Ophthalmol Soc.  2019 Jan;60(1):91-95. 10.3341/jkos.2019.60.1.91.

Ganglion Cell Analysis in an Optic Tract Syndrome Patient Previously Diagnosed with Glaucoma

• Kim J
• Park MR
• Jung Y

• KMID: 2431846
• DOI: http://doi.org/10.3341/jkos.2019.60.1.91

Abstract

PURPOSE
To report the results of ganglion cell analysis in a patient with optic tract syndrome who was previously diagnosed with glaucoma.
CASE SUMMARY
A 32-year-old male, who had been diagnosed with glaucoma 12 years ago, but had not visited an ophthalmology clinic since then, came to our clinic for evaluation of his glaucoma. Both eyes showed an increased cup-to-disc ratio and temporal pallor of the disc. Retinal nerve fiber layer (RNFL) optical coherence tomography showed thinning of the superior, inferior, and temporal peripapillary RNFL in both eyes. On ganglion cell analysis (GCA), ganglion cell layer thinning in the nasal region of the right eye and in the temporal region of the left eye was observed. The visual field test showed right incongruous homonymous hemianopsia. After the atrophic change of the left optic tract was confirmed by orbit magnetic resonance imaging, he was diagnosed with left optic tract syndrome.
CONCLUSIONS
We report the results of GCA in a case of optic tract syndrome, previously diagnosed as glaucoma. GCA can be useful when diagnosing optic tract syndrome.

Keyword

Ganglion cell analysis; Glaucoma; Optic nerve; Optic tract syndrome

MeSH Terms

Adult
Ganglion Cysts*
Glaucoma*
Hemianopsia
Humans
Magnetic Resonance Imaging
Male
Nerve Fibers
Ophthalmology
Optic Nerve
Optic Tract*
Orbit
Pallor
Retinaldehyde
Temporal Lobe
Tomography, Optical Coherence
Visual Field Tests
Retinaldehyde

Figure

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  Figure 1 Results of fundus photography. Both optic discs showed increased cup-disc ratio and mild temporal pallor.

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  Figure 2 Results of RNFL optical coherence tomography (OCT). RNFL OCT showed thinning of superior, inferior and temporal RNFL of both eyes. RNFL = retinal nerve fiber layer; N = nasal; T = temporal.

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  Figure 3 Results of ganglion cell analysis. On ganglion cell analysis, thinning of the ganglion cell layer was prominent in the nasal region of the right eye and the temporal region of the left eye respecting the vertical meridian.

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  Figure 4 Results of visual field analysis. Right incongruous homonymous hemianopsia was shown in Humphrey visual field test 24-2, which is in accordance with the retinal nerve fiber layer and ganglion cell analysis test results.

• 

  Figure 5 Mild atrophic change of the left optic tract was observed (arrow) in T2-weighted orbit magnetic resonance imaging.

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