Images in Neurology
March 2013

In Vivo Demonstration of Homonymous Hemimacular Loss of Retinal Ganglion Cells Due to a Thalamic Lesion Using Optical Coherence Tomography

Author Affiliations

Author Affiliations: Division of Neuroimmunology, Department of Neurology (Drs Oh, Sotirchos, Saidha, and Calabresi) and Retinal Imaging Research and Reading Center, Wilmer Eye Institute (Drs Ibrahim, Sepah, and Nguyen), The Johns Hopkins University, Baltimore, Maryland.

JAMA Neurol. 2013;70(3):410-411. doi:10.1001/jamaneurol.2013.605

A previously healthy 40-year-old woman presented with subacute onset of a left homonymous hemianopia. Contrast-enhanced magnetic resonance imaging of the brain revealed a T2-hyperintense lesion in the right thalamus, with associated subtle gadolinium enhancement (Figure 1), and a small periventricular lesion. Although her visual symptoms were improving, a new left-sided hemiparesis developed 3 weeks later. Additional magnetic resonance imaging of the brain showed extension of the original thalamic lesion into the right internal capsule, with persistent contrast enhancement. Her visual and motor symptoms gradually improved over 3 months.

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