Shahriar Amjadi, Richard Mills, John Landers, Jane Wells, Jamie Craig

Purpose: To demonstrate reduction in the thickness of the ganglion cell complex (GCC) on macular spectral domain optical coherence tomography (SD- OCT) in patients with posterior visual pathway lesions from a range of pathologies.
Method: A cohort of patients recruited from the Flinders Medical Centre Ophthalmology Department or from Eyemedics, South Australia, who had homonymous visual fteld loss from cortical injury were reviewed. All patients had Humphrey Visual Field testing and macular SD-OCT along with neu-roimaging conftrming the location of the brain damage.
Results: Eight patients were recruited in the case series (six male, two female). The mean age of the patients was 66.5 years (range 38-85 years). All patients displayed homonymous visual fteld loss corresponding with the area of brain damage as confirmed by radiological imaging. The causes of cortical fteld loss included ischaemic CVA (2), trauma
(4) or post-surgical excision of brain tumour (2). All patients displayed GCC loss consistent with the area of visual fteld loss as evidenced by macular SD-OCT of the GCC. This was regardless of the primary cause of the cerebral insult.
Conclusion: Cortical visual fteld loss can lead to a retrograde loss of the GCC of the macula as evidence by SD-OCT. This is independent of the primary pathology, whether it be trauma, stroke or after surgical resection of a tumour. Further studies are required to elucidate the mechanism of this phe- nomenon. Ophthalmologists using GCC for screening and monitoring glaucoma progression need to be aware of this ftnding.