J Korean Ophthalmol Soc.  2019 Feb;60(2):201-204. 10.3341/jkos.2019.60.2.201.

Homonymous Quadrantanopia Caused by Occipital Lobe Ulegyria

• Lee J
• Kim WJ

• KMID: 2438082
• DOI: http://doi.org/10.3341/jkos.2019.60.2.201

Abstract

PURPOSE
We report a case of homonymous quadrantanopia caused by occipital lobe ulegyria.
CASE SUMMARY
A 23-year-female was referred to our clinic because of a visual field defect incidentally discovered during preoperative evaluation for refractive surgery at another clinic. However, she did not report any symptoms. She had no systemic diseases. Visual acuity was 20/20 in both eyes, and the color vision test was normal. Both pupils exhibited normal responses to light and near stimulations. In fundus examinations, the right optic disc was normal and the left contained drusen. Automated perimetry revealed right lower homonymous quadrantanopia with macular sparing. Brain magnetic resonance imaging revealed areas of ulegyria involving the left occipital lobe, consistent with the visual field defect. A follow-up visual field test performed 5 months later yielded the same result.
CONCLUSIONS
Neuroimaging should be performed in patients with homonymous visual field defects to determine the location and etiology of the brain lesions. Occipital lobe ulegyria can cause homonymous quadrantanopia in the absence of any neurological problem.

Keyword

Brain injuries; Hemianopsia; Visual fields

MeSH Terms

Brain
Brain Injuries
Color Vision
Follow-Up Studies
Hemianopsia*
Humans
Magnetic Resonance Imaging
Neuroimaging
Occipital Lobe*
Pupil
Refractive Surgical Procedures
Visual Acuity
Visual Field Tests
Visual Fields

Figure

• 

  Figure 1 Images of the fundus photograph at the initial visit. The right eye showed normal appearance of optic disc (A). The left eye showed optic disc drusen (B).

• 

  Figure 2 The result of visual field test (Humphrey Field Analyzer, Carl Zeiss Meditec, Inc., Dublin, OH, USA) performed at the initial visit. The visual field test demonstrated the right lower homonymous quadrantanopia with macular sparing (A: left eye, B: right eye).

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  Figure 3 The coronal and axial view of the brain magnetic resonance imaging (MRI, A: axial view, B: coronal view). The MRI demonstrates the focal involvement of ulegyria at the left occipital lobe (A: arrow, B: arrowhead).

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