[Case of long-term metamorphopsia caused by multiple cerebral infarction]

This report presents the case of a 79-year-old right-handed woman. One day on waking, she realized that the faces of her family members appeared distorted. She consulted an ophthalmologist at a nearby clinic in the vicinity and was diagnosed with left homonymous hemianopsia. Since a cerebrovascular disease was suspected, she was referred to clinic A. Brain MRI revealed a cerebral infarction in the right temporo-occipital area. Neurologically there was no other significant sign besides left homonymous hemianopsia and the visual disorder. Metamorphosia was the major visual disorder detected; in the patient's word "left half of the faces of people walking on the street in the opposite direction appeared distorted; they looked like monsters." With conservative medical treatment, the condition remitted; nevertheless, the right visual field metamorphopsia persisted for over 3 years. This unique case suggests that metamorphopsia occurs due to lesions in not only the contralateral parietooccipital lobe, as usually reported, but also in other resions, including the ipsilateral hemisphere.