Homonymous OCT-GCIPL Quadrantanopia without a Visual Field Defect

Abstract

A 37-year-old woman with a large left parieto-occiptal porencephalic cyst was referred by neurosurgery to rule out papilledema. Her visual acuity was 20/20, there was no relative afferent pupillary defect, and Humphrey 24-2 SITA-Fast visual field testing was unremarkable (Fig A). There was no papilledema, but OCT of the ganglion cell-inner plexiform layer (GCIPL) showed right homonymous quadrantanopic thinning (Fig B). Review of the magnetic resonance imaging (top, sagittal T1; bottom left, fluid-attenuated inversion recovery [FLAIR]; bottom right, axial T2) showed a large cerebrospinal fluid–containing cyst compressing the parieto-occipital lobes in the location of the left retrochiasmal visual pathways (Fig C) (Magnified version of Fig A-C is available online at www.aaojournal.org).