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May 1973

Isolated Homonymous Hemianopia: A Review of 104 Cases

Author Affiliations

From the Wills Eye Hospital and Research Institute, Philadelphia. Dr. Trobe is presently at Malcolm Grow USAF Medical Center, Andrews AFB, Washington, DC.

Arch Ophthalmol. 1973;89(5):377-381. doi:10.1001/archopht.1973.01000040379005

In a retrospective review of 104 cases of homonymous hemianopia, cerebral infarction was the diagnosis in 89% of the patients. This diagnosis was twice as common as reported in a previous series, which included other neurologic findings along with homonymous field defects.

The majority of patients were white and between the ages of 50 and 70 years, often having a history of vascular disease. Eighty-eight percent of the patients showed a static or improved clinical course, while only 12% showed visual field or central nervous system deterioration.

A routine work-up, excluding contrast studies, was sufficient to select 11 out of the 12 cases that were not due to infarction. Data that were suggestive of a noninfarctive cause were patients aged under 40 years, incongruous field defects, abnormal skull x-ray films, abnormal opticokinetic nystagmus, and elevated levels of spinal fluid protein.