PMC7174762_01
Magnetic Resonance Imaging of a left retro-chiasmal optic pathway glioma visualized on (A) Axial T2-MRI and (B) Coronal T1 post gadolinium MRI.
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F1
Imaging (MRI). This is depicted in Figure 1. It is uncertain for what duration she may have had this optic tract glioma as she was entirely asymptomatic from a visual perspective and this was the first time she underwent neuroimaging studies. On examination, her visual acuity was 20/20 bilaterally with no deficits noted on 24-2 Humphrey Visual Field analysis (mean deviation: + 0.18dB OD and -0.42dB OS) (see Supplementary Figures 1, 2).
Optical coherence tomography (A) pRNFL and (B) Macular cube analysis by OCT demonstrates thinning of the nasal GCL-IPL OD and temporal GCL-IPL OS. Thicknesses reported are in micrometers. This represents a topographic pattern of GCL-IPL thinning that would correspond to a right homonymous visual field deficit, implicating a left optic tract localization.
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F2
On examination, her visual acuity was 20/20 bilaterally with no deficits noted on 24-2 Humphrey Visual Field analysis (mean deviation: + 0.18dB OD and -0.42dB OS) (see Supplementary Figures 1, 2). OCT analysis revealed normal pRNFL thickness with average thickness 81 mum OD and 75 mum OS (Figure 2A). Most strikingly, however, despite preserved visual acuity and visual fields, OCT analysis of GCL-IPL thickness revealed a homonymous pattern of GCL-IPL atrophy (Figure 2B) reflecting loss of axons arising from the nasal retinal fibers of the right-eye and temporal retinal fibers of the left-eye.