Neurology Cases: Ganglion Cell Patterns Localize Anterior Visual Pathway Lesions

In the management of pituitary tumors compressing the optic chiasm, measurement of retinal ganglion cell layer thickness by optical coherence tomography provides an objective and reliable assessment of anterior visual pathway lesions to complement visual field examinatio.

(Figure 1: Pituitary adenoma [red arrow] is seen on T2WI [D] compressing the anterior optic chiasm, corresponding to diffuse visual field loss [dark area] in the ipsilateral eye, and superior temporal junctional scotoma in the contralateral eye [A] ] and optical coherence tomography [D] diffuse ganglion cell thinning in the ipsilateral eye [blue zone] and infranasal thinning in the contralateral eye; central compression corresponds to bilateral temporal hemianopia [B] and bilateral nasal ganglia Cell thinning [E]; posterior compression corresponds to [discordant] contralateral homonymous hemianopia [C] as well as temporal ganglion cell thinning in the ipsilateral eye and nasal thinning in the contralateral eye [F])

(Figure 2: A: Pituitary adenoma [pink] involving the right optic nerve and left inferior medial optic nerve [black arrow] compresses the anterior chiasm [grey]; B: Pituitary adenoma compresses the central chiasm; C: Pituitary gland Tumor involving the left optic tract compresses the posterior chiasm)

[references]

: .