|LETTER TO THE EDITOR
|Year : 2015 | Volume
| Issue : 1 | Page : 63-64
Partial optic atrophy and homonymous quadrantanopia in a patient with occipital encephalomalacia
Ali Akal1, Tugba Goncu1, Nurefsan Boyaci2, Bahattin Celik3, Ozcan Kocaturk4
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 Publication||2-Mar-2015|
Department of Ophthalmology, Harran University Medical School, Sanliurfa
Source of Support: None, Conflict of Interest: None
|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 12];5:63-4. Available from: http://www.ijciis.org/text.asp?2015/5/1/63/152353
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.  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|
Click here to view
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|
Click here to view
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.  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.  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|| |
Trobe JD, Lorber ML, Schlezinger NS. Isolated homonymous hemianopia. A review of 104 cases. Arch Ophthalmol 1973; 89:377-81.
Hoyt WF, Newton TH. Angiographic changes with occlusion of arteries that supply the visual cortex. NZ Med J 1970;72:310-6.
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.
[Figure 1], [Figure 2]