Temporal Crescent Syndrome with Magnetic Resonance Correlation

Abstract

A young woman with a history of controlled hypertension noted a suddenly decreased peripheral temporal field in the left eye. This occurred after moderate peripartum hypertension. A monocular peripheral temporal crescentic defect could be plotted on Goldmann visual fields despite a normal dilated peripheral retinal examination and normal disc appearance. A dilated parieto-occipital sulcus could be seen on computed tomography, and magnetic resonance imaging showed changes consistent with atrophy and gliosis in the cuneus, precuneus, and anterior calcarine cortex surrounding the parieto-occipital sulcus. By magnetic resonance imaging, this can be seen to comprise less than 10% of the visual cortex, as suggested by the Horton and Hoyt revised Holmes map. The temporal crescent syndrome is a rare monocular retrochiasmatic visual field defect that can be correlated to a lesion along the parieto-occipital sulcus.