Atlas of Ophthalmology

Combined Simple and Glaucomatous Optic Atrophy with Homonymous Retinal Nerve Fiber Degeneration (MR, DTI, OCT, wwPerimetry)

Brain and Optical Pathway
Male, 59 years Ophthalmoscopy: OD/OS combined simple and glaucomatous optic atrophy MRI: white matter containing single unspecific lesions DTI: Rarefied optic radiations right > left, in the middle area of the right optic radiation a derogated signal OCT mean retinal nerve fiber thickness: temporal homonymeous diminuished retinal nerve fiber thickness, mean OD 53 µm, mean OS 55 µm. White-white-perimetry: Unspecific defects, Mean Defect OD 17.8dB, OS 18.2dB. Best corrected visual acuity (decimal):OD 0.6, OS 0.8. IOP: OD 14mmHg, OS 14mmHg. Assessment: 3rd neuron: A reduced retinal nerve fiber layer thickness is present predominantly in the temporal area of both eyes and includes the papillo-macular bundle (homonymeous defect). The advanced visual field defect is focussed likewise on the area between papilla and macula. Nevertheless, there are also diffuse visual field defects predominantly in the visual field that belongs to the temporal retina. 4th neuron: The optic radiation is clearly smaller in its cortical end portion than in its anterior part. The damage tends to be more pronounced in the central axons that belong to the macula than in the periphery.

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