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Table of Contents
LETTER TO THE EDITOR
Year : 2015  |  Volume : 5  |  Issue : 1  |  Page : 63-64

Partial optic atrophy and homonymous quadrantanopia in a patient with occipital encephalomalacia


1 Department of Ophthalmology, Harran University Medical School, Sanliurfa, Turkey
2 Department of Radiology, Harran University Medical School, Sanliurfa, Turkey
3 Department of Neurosurgery, Harran University Medical School, Sanliurfa, Turkey
4 Department of Neurology, Harran University Medical School, Sanliurfa, Turkey

Date of Web Publication2-Mar-2015

Correspondence Address:
Ali Akal
Department of Ophthalmology, Harran University Medical School, Sanliurfa
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5151.152353

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How to cite this article:
Akal A, Goncu T, Boyaci N, Celik B, Kocaturk O. Partial optic atrophy and homonymous quadrantanopia in a patient with occipital encephalomalacia. Int J Crit Illn Inj Sci 2015;5:63-4

How to cite this URL:
Akal A, Goncu T, Boyaci N, Celik B, Kocaturk O. Partial optic atrophy and homonymous quadrantanopia in a patient with occipital encephalomalacia. Int J Crit Illn Inj Sci [serial online] 2015 [cited 2019 Nov 22];5:63-4. Available from: http://www.ijciis.org/text.asp?2015/5/1/63/152353

Dear Editor,

In diseases affecting the afferent visual pathways, according to the localization of the lesion to see, different symptoms can occur. The ones that we can evaluate in a easiest way in clinic are the contralateral homonymous visual field effects that emerge behind chiasm resulting in the affect. [1] Herein we aimed to present an image to demonstrate a partial optic atrophy and homonymous quadrantanopia with occipital encephalomalacia.

A 16-year-old male patient applied to the eye clinic due to complaints of not seeing far well.

In the history there was no trauma, surgical intervention and birth asphyxia. In the eye examination, -1.75 myopic refractive errors were present bilaterally. The best corrected visual acuity was 1.0 bilaterally. Partial optic pallor was present in both eyes at fundus examination. Slit-lamp examination and intraocular pressure were normal. Homonymous quadrantanopia was determined at the peripheral visual field examination with threshold 30-2 test [Figure 1].
Figure 1: Homonymous quadrantanopia at peripheral visual field examination with threshold 30-2 test

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Findings consistent with occipital encephalomalacia have been reported on cerebral magnetic resonance imaging [Figure 2]. Occipital encephalomalacia diagnosis was confirmed at pediatric neurology consultation. Laboratory studies were normal. Any pathological findings required to be treated were not detected at systemic examination. Due to unilateral lesion, not affecting vision, and lack of systemic clinical manifestations it was considered that it occurred after vascular events. The patient is under periodic control for 3 years as signs and symptoms did not change.
Figure 2: Occipital encephalomalacia at cerebral magnetic resonance imaging

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The most prominent features of the occipital lobe lesions are symmetrical contralateral homonymous hemianopia and central (macular) vision is preserved in most of them. Despite the existence of views that reason for this feature may be fixation artifact or bilateral cortical representation, and the most accepted theory of vascular occlusive lesions in the macula source from the region of the middle cerebral artery. [2] Homonymous hemianopia is caused most commonly by cerebral artery infarction. Posterior cerebral artery infarcts represent about 5% to 10% of all strokes in a general population. [3] Visual acuity is not affected unless there exists a bilateral lesion. Hemianopia placed behind the chiasm lesions show different features. Visual field defects are usually permanent defects.

 
   References Top

1.
Trobe JD, Lorber ML, Schlezinger NS. Isolated homonymous hemianopia. A review of 104 cases. Arch Ophthalmol 1973; 89:377-81.  Back to cited text no. 1
    
2.
Hoyt WF, Newton TH. Angiographic changes with occlusion of arteries that supply the visual cortex. NZ Med J 1970;72:310-6.  Back to cited text no. 2
    
3.
Brandt T, Steinke W, Thie A, Pessin MS, Caplan LR. Posterior cerebral artery territory infarcts: Clinical features, infarct topography, causes and outcome. Multicenter results and a review of the literature. Cerebrovasc Dis 2000;10:170-82.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2]



 

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