Browsing by Subject "Visual field defect"

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    Metastatic paraganglioma presenting as ajunctional scotoma
    (Elsevier, 2021-12-31) Khodeiry, Mohamed M.; Lind, John T.; Pasol, Joshua; Lam, Byron L.; Lee, Richard K.; Ophthalmology, School of Medicine
    Purpose: To report a unique case of metastatic paraganglioma presenting as a junctional scotoma. Observations: A 38-year-old Caucasian man with a history of abdominal paraganglioma presented with minimally blurred vision 20/25 visual acuity in the left eye. The patient was found to have a junctional scotoma upon visual field testing. Cranial MRI revealed a large peri-clival mass compressing the pre-chiasmal optic nerves and other loci of metastatic disease. Intracranial masses, including metastases, can present with a relatively intact central acuity and nonspecific visual symptoms. Conclusions and importance: To the best of our knowledge, this is the first report of metastatic paraganglioma causing a junctional scotoma. In cases with junctional scotoma, careful neuro-ophthalmic assessment and imaging are of paramount importance, even in patients with excellent visual acuity.
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    The 'Fault' Lies in the Choroid: Peripapillary Intrachoroidal Cavitation Presenting with Progressive Vision Loss
    (Taylor & Francis, 2022-01-25) Belamkar, Aditya V.; Dolan, Joseph; Olatunji, Sunday; Bhatti, M. Tariq; Chen, John J.; Mansukhani, Sasha A.; Ophthalmology, School of Medicine
    A 55-year-old male was referred to the Neuro-ophthalmology clinic due to gradual onset, progressive vision loss. On fundus examination a subtle yellow-orange peripapillary lesion was detected in the left eye. Optical coherence tomography with radial scanning illustrated retinal nerve fibre layer thinning as well as an area of intrachoroidal cavitation that corresponded to the lesion. Visual field testing showed a left inferior arcuate defect. Magnetic resonance imaging of the brain and orbit, and laboratory testing was unremarkable. Clinical examination, imaging, and testing were consistent with peripapillary intrachoroidal cavitation (PICC). Follow-up with serial visual field testing showed mild progression of the field defect. While PICC is not well understood in the literature, studies have reported associated risk factors including pathological myopia, older age, increased ocular axial length, chorioretinal atrophy, and vascular abnormalities. Importantly, glaucoma-like visual field defects as well as structural changes have been noticed in a high proportion of patients with PICC. While these alterations are evident, the pathogenic relationship between them is yet to be uncovered. Treatment with anti-glaucoma medications has been suggested, however, the evidence remains scarce for its true benefits. Care providers must be aware of the presentation of a yellow-orange peripapillary lesion with an associated visual field defect to accurately diagnose and manage this condition.