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September 1981

Transsynaptic Degeneration

Arch Ophthalmol. 1981;99(9):1654. doi:10.1001/archopht.1981.03930020528032

To the Editor.  —Since the observations by Van Buren1 of acquired transsynaptic degeneration in the anterior visual system of adolescent, nonhuman primates after occipital lobectomy, investigators have looked for evidence of similar acquired transsynaptic degeneration in human adults. It has been suggested that transsynaptic degeneration could occur if the period after cortical insult was sufficient.

Report of a Case.  —We examined an 86-year-old woman with a history of a cerebrovascular accident at age 29 years, 57 years previously, leaving her with a left-sided hemiparesis and a complete left-sided homonymous hemianopsia. The hemiparesis gradually resolved, but the hemianopsia remained. Findings from our examination showed the patient's visual acuity was 20/60 at distance and near in both eyes from bilateral, nuclear cataractous changes. Visual fields showed a complete left-sided homonymous hemianopsia. Extraocular movements were full. Optokinetic nystagmus was symmetric and equal for targets going to both the right and left sides.