[Visual impairment in posterior cortical atrophy--visual variant of Alzheimer's disease in the ophthalmic practice]

Posterior cortical atrophy, also known as visual variant of Alzheimer's disease, is a rare dementia syndrome characterized by the predominant visuospatial functional deficit. The ophthalmologist is usually the first specialist consultant the patient is referred to with such complaints as: reading difficulty, face recognition problems, feeling of visual field restriction, difficulty perceiving more than one object at a time, difficulty grabbing objects under visual control, recognizing familiar surroundings, watching television or driving a car. Posterior cortical atrophy is one of early-onset (below 65 years of age) dementia syndromes and is most often associated with Alzheimer's pathology. Visual impairment is due to the disturbance of one or two visual pathways in the brain (dorsal--analyzing the stimulus localization, ventral--enabling the stimulus recognition) and subsequent atrophy of parietal and/or occipital lobe. The article presents the clinical characteristics and diagnostic criteria of posterior cortical atrophyas well as abnormal findings of the extended ophtalmic examination and methods utilised in differential diagnosis of cortical vision deficits. Early diagnosis of posterior cortical atrophy can be ensured by the close cooperation between the ophtalomogist and a neurologist specializing in the diagnosis of neurodegenerative diseases.