Transsynaptic degeneration in the visual system; report of a case.

Abstract

THE OCCASION for this report was the finding of progressive development of bilateral primary optic nerve atrophy five and onehalf years after an extensive penetrating gunshot wound of both occipital lobes. There was no definite evidence of injury to the optic nerves or tracts to account for this atrophy, and it appeared probable that a transsynaptic degeneration had occurred. A search of the literature revealed that transsynaptic degeneration in the visual system had been mentioned by several writers but that few case reports had been included. Because degeneration of the optic nerve is not ordinarily anticipated after lesions of the occipital lobe, we believe it advisable that this problem be reviewed. When an axon within the central nervous system is sectioned, the distal segment degenerates up to the synapse but produces no pathologic change in the cell on which it terminates. There are a few instances in which degeneration of