Case Series: Bilateral Homonymous Visual Field Defects Due to Bilateral Ischemic Strokes
Eleni Papageorgiou1, Nikolaos Anthis2, Theodora Stathi3
1Ophthalmology Group, University of Leicester, Leicester, United Kingdom.
Summary
Bilateral strokes causing homonymous visual field defects are rare but crucial to identify. Prompt diagnosis requires neuroimaging and visual field testing to understand these complex retinotopic patterns.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Bilateral strokes leading to homonymous visual field defects are uncommon.
- Early recognition is vital due to potential vague patient symptoms.
Observation:
- Three patients with bilateral ischemic strokes presented with diverse homonymous visual field defects.
- Case 1: Bilateral superior altitudinal hemianopia from sequential occipital strokes.
- Case 2: Mixed homonymous defects from sequential occipital and thalamic strokes.
- Case 3: Bilateral superior altitudinal hemianopia from concurrent occipital strokes.
Findings:
- Perimetry and MRI confirmed bilateral occipital or thalamic involvement.
- Visual field defects correlated with the location and extent of ischemic lesions.
- Patients experienced sequential or concurrent strokes, impacting awareness of vision loss.
Implications:
- Highlights the importance of neuro-ophthalmological examination in suspected bilateral strokes.
- Emphasizes correlating visual field patterns with neuroimaging for accurate diagnosis.
- Underscores the retinotopic organization of the striate cortex in visual field deficits.
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