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Neurological picture
Bitemporal hemianopsia in frontonasal dysplasia, callosal agenesis, basal meningocele and eye abnormalities
  1. Florian Huiskes1,
  2. Viola Koen2,
  3. Frank de Beer3
  1. 1University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
  2. 2Department of Radiology, Kennemer Gasthuis, Haarlem, The Netherlands
  3. 3Department of Neurology, Kennemer Gasthuis, Haarlem, The Netherlands
  1. Correspondence to Florian Huiskes, University of Amsterdam, Academic Medical Center, Nicolaas Berchemstraat 7-C 1073VR, Amsterdam, The Netherlands; f.huiskes{at}amc.uva.nl

http://dx.doi.org/10.1136/jnnp-2012-304741

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    A 42-year-old female was referred to our department by an ophthalmologist because of newly discovered bitemporal hemianopsia (figures 1A–C). Over the past years she had increasing difficulty reading subtitles and noticed overlooking passing vehicles when crossing roads.

    Figure 1

    Bitemporal hemianopsia of the patient. (A) Static perimetry using the Humphrey Field Analyzer of respectively the left and right eye showing bitemporal hemianopsia. The black lateral visual fields do not register light, representing bitemporal hemianopsia. Her best visual area is illustrated as the most regular pattern of dots, seen mostly in the centre when compared with the periphery, which represents concentric visual field loss in both eyes. (B, C) Goldmann's kinetic perimetry of the left (B) and right (C) eye showing bitemporal hemianopsia. In patients with severe vision loss (visual acuity worse than 20/200) or severe neurological deficits, a Goldmann perimetry is preferred. The drawn lines represent different light sizes and intensity. (Eye fixation is normal with patient's third-degree horizontal nystagmus). This figure is only reproduced in colour in the online version.

    The patient was born with third-degree horizontal nystagmus, strabismus convergens and congenital morning glory …

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    Footnotes

    • Contributors FH, VK and FdB all identified the patient and wrote the article. FH and FdB corresponded with the patient. FH designed the pictures and obtained informed consent. VK obtained the MRI pictures.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.