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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
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Neuro-Ophthalmology
Case 5
Patient Presentation: A 44-year-old male was referred to a neuro-ophthalmology clinic for a new visual field defect. His visual acuity was 20/20 OU. OCT ganglion cell – inner plexiform layer (GCIPL) analysis is shown below.
Question: Based on the OCT images, what visual field defect do you expect the patient present with?
Question: A right relative afferent pupillary defect was noted in the patient. Where does the lesion localize?
Question: Based on the retrochiasmal location of the lesion at the optic nerve tract, what type of deficit do you expect to see in OCT RNFL?
Learning Objectives:
1. Describing the presentation and localization of homonymous hemianopia visual field defects
2. Recognizing bow-tie atrophy defects on RNFL OCT.
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