Visual Fields and Ocular Coherence Tomography Predict Location of the Intracranial Lesion

A 19-year-old woman presented to the neuro-ophthalmology clinic with a 3-month history of headaches and decreased vision in the right eye (RE). Visual acuity was 20/30 in the RE and 20/ 20 in the left eye (LE). There was right relative afferent pupillary defect. Ophthalmoscopy demonstrated subtle band atrophy of right optic nerve and was normal on the left. Humphrey 24-2 visual field (VF) testing revealed left homonymous hemianopia as well as nerve fiber layer defect in the RE (Figure 1A). Ocular coherence tomography (OCT) of the ganglion cell-inner plexiform layer (GC-IPL) demonstrated generalized thinning in RE and nasal loss