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Case 31


Patient Presentation: A 76-year-old woman was referred for constant blurry vision in both eyes over the last 6 years. Her past medical history was significant for mild hypertension and joint inflammation. Her medications included prednisone 10 mg PO and vitamin supplementation. On examination, her visual acuity was 20/20 OD and 20/20 OS. IOP was 12 OU. There was no RAPD. IOP was 12 OU. Dilated fundus examination was performed and was unremarkable.


Humphrey visual field testing (24-2) was performed and is shown below:


Question 1: What visual field defect(s) is/are present in this patient?

OCT RNFL and ganglion cell analysis (GCA) was performed and is shown below:


Question 2: What pattern of changes is demonstrated by the GCA?

Question 3: What was the most likely cause of this patient’s VF defect?

Learning Objectives:

  1. To understand the visual field and OCT findings of longstanding and bilateral retrochiasmal lesions.

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