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Types of Homonymous Visual Field Defects

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Homonymous Visual Field Defects

Abstract

Retrochiasmal brain damage can lead to various types of homonymous visual field defects (HVFDs), with the occipital lobe being the most common lesion location, followed by the optic radiation, the optic tract, and lateral geniculate nucleus (LGN). The etiology depends on the age of the patient. Older patients tend to have vascular lesions, whereas younger patients may have tumors, traumatic injuries, and arteriovenous malformations. HVFDs can be classified according to their size, shape, macular sparing, and congruency, giving rise to a variety of perimetric findings. Complete homonymous hemianopias are nonlocalizing and may be caused by lesions in any part of the retrochiasmal visual pathway, including the optic tract, LGN, optic radiation, and occipital lobe. However, a highly congruous complete homonymous hemianopia is usually due to an occipital lobe lesion. Homonymous quadrantanopias usually result from lesions of the occipital lobe and the optic radiation. Less frequent types of HVFDs are paracentral circumscribed homonymous scotomas due to small lesions at the tip of the occipital lobe, homonymous sectoranopias in lesions of the LGN, and peripheral HVFDs due to lesions in the intermediate striate cortex. A unique HVFD is the “temporal crescent,” after damage to the most anterior portion of the occipital lobe. Bilateral homonymous visual field defects due to bilateral postchiasmatic lesions may present as checkerboard visual fields or bilateral altitudinal defects. Such deficits may pose a diagnostic dilemma, as they have to be differentiated from anterior ischemic optic neuropathy, ischemic retinal lesions, choroiditis, choroidal colobomas, glaucoma, optic nerve hypoplasia, tilted discs, or drusen.

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Authors and Affiliations

  1. Department of Ophthalmology, University Hospital of Larissa, Mezourlo, Larissa, 41110, Greece

    Eleni Papageorgiou MD, PhD, FEBO & Evangeli Tsironi-Malizou

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  1. Eleni Papageorgiou MD, PhD, FEBO
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  2. Evangeli Tsironi-Malizou
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Correspondence to Eleni Papageorgiou MD, PhD, FEBO .

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Editors and Affiliations

  1. Department of Ophthalmology and Optometry, St. Anne’s University Hospital, Brno, Czech Republic

    Karolína Skorkovská

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Papageorgiou, E., Tsironi-Malizou, E. (2017). Types of Homonymous Visual Field Defects. In: Skorkovská, K. (eds) Homonymous Visual Field Defects. Springer, Cham. https://doi.org/10.1007/978-3-319-52284-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-52284-5_5

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