Cárdenas-Belaunzarán Jorge, Cerrillo-Avila Karen A
Neuro-Ophthalmology Department, Asociación para Evitar la Ceguera en México, I.A.P., Mexico City, Mexico.
Independent researcher, Mexico City, Mexico.
Neuroophthalmology. 2023 Sep 15;48(1):30-36. doi: 10.1080/01658107.2023.2257311. eCollection 2024.
Vision specialists will benefit from increased awareness of posterior cortical atrophy (PCA) syndrome. Failure to adequately identify the chief complaint as a visual symptom may lead to incorrect diagnosis or diagnostic delay. A previously healthy, 59-year-old woman presented with a 5-year history of 'losing her stuff'. Upon psychiatric and neuro-ophthalmological evaluation, this symptom was better recognised as a feature of visual agnosia and simultanagnosia. She also presented with multiple previously unrecognised symptoms indicative of higher visual processing dysfunction, such as alexia without agraphia, ocular motor apraxia, optic ataxia, prosopagnosia, akinetopsia and topographagnosia, so further assessment to investigate for PCA was carried out. After a work-up including cognitive assessment, brain structural/functional imaging, and laboratory tests she was diagnosed with visual-variant Alzheimer's disease. Patients with PCA merit a detailed review of their symptoms, as well as the use of office tests such as cognitive evaluation tools, different types of perimetry, colour vision tests, and non-delayed psychiatric consultation for correct management and assessment. This report will emphasise five key aspects to be considered when evaluating patients with PCA.
视力专家将从对后皮质萎缩（PCA）综合征的更多认识中受益。未能充分将主要诉求识别为视觉症状可能导致诊断错误或诊断延迟。一名此前健康的59岁女性，有5年“丢失物品”的病史。经过精神科和神经眼科评估，该症状被更好地识别为视觉失认和同时失认的特征。她还出现了多种此前未被识别的症状，提示高级视觉处理功能障碍，如失读不伴失写、眼球运动失用、视觉性共济失调、面容失认、运动不能性失视和地形定向障碍，因此对其进行了进一步评估以排查PCA。经过包括认知评估、脑结构/功能成像和实验室检查在内的一系列检查后，她被诊断为视觉变异型阿尔茨海默病。PCA患者需要对其症状进行详细评估，同时使用办公室检查，如认知评估工具、不同类型的视野检查、色觉检查，以及及时进行精神科会诊，以进行正确的管理和评估。本报告将强调在评估PCA患者时需要考虑的五个关键方面。
