Ishikawa H, Tanabe Y
Department of Ophthalmology, Nihon University, School of Medicine.
Rinsho Shinkeigaku. 1991 Sep;31(9):1035-8.
A 45-year-old man of bilateral occipital infarction with central homonymous hemianopia is reported. He was admitted to our hospital with complaints of visual loss and large central scotoma on both eyes. Pupillary light reaction and ocular fundi were normal. On admission, bilateral retrobulbar optic neuritis was suspected. However, congruous, irregular central scotomas with vertical step were observed in both eyes with Goldmann perimetry. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) revealed the infarction in bilateral occipital tips. Bilateral central homonymous hemianopia is considered to be rare and a case in which occipital lobe lesions were detected with X-ray CT and MRI has not been reported. We stress that bilateral central scotomas with vertical step indicate bilateral occipital lesions.
报告了一名45岁双侧枕叶梗死伴中心性同向偏盲的男性患者。他因双眼视力丧失和大的中心暗点而入院。瞳孔对光反射和眼底正常。入院时，怀疑为双侧球后视神经炎。然而，用戈德曼视野计检查发现双眼均有一致的、不规则的伴有垂直阶梯的中心暗点。X线计算机断层扫描（CT）和磁共振成像（MRI）显示双侧枕叶尖端梗死。双侧中心性同向偏盲被认为较为罕见，且尚未有通过X线CT和MRI检测出枕叶病变的病例报道。我们强调，伴有垂直阶梯的双侧中心暗点提示双侧枕叶病变。
