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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