Departments of Clinical Neurosciences (FEC) and Surgery (YPS), Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Neuroophthalmol. 2021 Jun 1;41(2):e225-e227. doi: 10.1097/WNO.0000000000001014.
Hemorrhagic lateral geniculate nucleus (LGN) insults are rare but have been reported in association with tumors, vascular malformations, and trauma. The localization of LGN lesions is facilitated by recognition of pathognomonic visual field defects. A 21-year old woman developed a sudden onset painless left homonymous horizontal sectoranopia. Magnetic resonance imaging revealed a hemorrhagic cavernous malformation of the right temporal lobe. Optical coherence tomography (OCT) and Humphrey perimetry findings localized the lesion to the right LGN. Specifically, OCT testing revealed a right homonymous sectoranopia pattern of hemi-retinal macular ganglion layer-inner plexiform layer (mGCIPL) thinning contralateral to the left sided visual field defect. The OCT pattern reflected retrograde neuroaxonal degeneration from the right LGN lesion. This case highlights a unique pattern of mGCIPL thinning characteristic for a posterior lateral choroidal artery injury, affecting the LGN. These findings illustrate how functional eloquence correlates with topographical elegance in the afferent visual pathway.
出血性外侧膝状体（LGN）损伤较为罕见，但已有报道称其与肿瘤、血管畸形和外伤有关。通过识别特征性的视野缺损，可以帮助定位 LGN 病变。一名 21 岁女性突发无痛性左侧同向水平扇形视野缺损。磁共振成像显示右侧颞叶出血性海绵状畸形。光学相干断层扫描（OCT）和 Humphrey 视野计检查结果将病变定位在右侧 LGN。具体来说，OCT 检查显示右侧同向扇形视野缺损模式的半视网膜神经节细胞-内丛状层（mGCIPL）变薄，与左侧视野缺损相对应。OCT 模式反映了来自右侧 LGN 病变的逆行神经轴突变性。本病例突出了一种独特的 mGCIPL 变薄模式，特征为后部外侧脉络膜动脉损伤，影响 LGN。这些发现说明了功能优势如何与传入视觉通路的拓扑优雅相关。
