Posterior Cortical Atrophy Presenting with Superior Arcuate Field Defect

Area of Science:

• Neuro-ophthalmology
• Neurodegenerative Diseases
• Geriatric Medicine

Background:

• Visual field defects can stem from various causes, including ocular and neurological conditions.
• Posterior cortical atrophy is a rare neurodegenerative syndrome primarily affecting visual processing.
• Benson's syndrome, a form of Alzheimer's disease, is characterized by visual and visuospatial deficits.

Purpose of the Study:

• To describe a unique case of Benson's syndrome presenting with progressive visual field loss.
• To correlate clinical presentation, neuroimaging findings, and neuropsychiatric assessment in a patient with Benson's syndrome.
• To enhance understanding of the visual manifestations of posterior cortical atrophy.

Main Methods:

• Case report of an 80-year-old female with a 5-year history of visual decline.
• Serial ophthalmological examinations including visual field testing.
• Repeated neuroimaging (MRI/CT) to assess for posterior cortical atrophy.
• Comprehensive neuropsychiatric evaluation.

Main Results:

• The patient exhibited progressive arcuate visual field defects evolving into incongruous homonymous hemianopia.
• Neuroimaging confirmed progressive posterior cortical atrophy.
• Clinical symptoms and signs were consistent with a diagnosis of Benson's syndrome.
• Intraocular pressure remained low throughout the observation period.

Conclusions:

• Benson's syndrome should be considered in the differential diagnosis of elderly patients with progressive visual field defects, even with normal intraocular pressure.
• Posterior cortical atrophy can manifest with significant visual field deficits.
• This case underscores the complex interplay between neurodegeneration and visual impairment.