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Neuropediatrics 2018; 49(02): 142-149
DOI: 10.1055/s-0037-1618569
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Homonymous Hemianopia in Children and Adolescents: An MRI Study

Manja Haaga
1   Department of Pediatric Neurology and Developmental Medicine, University Childreńs Hospital, Tübingen, Germany
,
Susanne Trauzettel-Klosinski
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
,
Anna Krumm
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
,
Stephan Küster
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
,
Iliya Ivanov
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
3   ZEISS Vision Science Lab, Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Germany
,
Angelika Cordey
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
,
Claudia Gehrlich
2   Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
,
Martin Staudt
1   Department of Pediatric Neurology and Developmental Medicine, University Childreńs Hospital, Tübingen, Germany
4   Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen Klinik Vogtareuth, Vogtareuth, Germany
› Author Affiliations
Further Information

Publication History

09 July 2017

26 November 2017

Publication Date:
19 January 2018 (online)

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Abstract

Aim Diagnosing homonymous hemianopia (HH) in children can be difficult due to inability to comply with perimetry. Therefore, HH can often only be suspected by magnetic resonance imaging (MRI) showing lesions to the retrochiasmatic visual pathways. The aim of our retrospective observational cross-sectional study was to improve the radiologic detection of HH.

Methods MRIs of 21 subjects (5–17 years old) with ophthalmologically confirmed HH (14 complete, 7 incomplete hemianopias) were analyzed. In addition, we asked four questions looking at everyday problems possibly related to the HH. The questions asked for (1) problems in avoiding objects/people, (2) bumping into objects/people, (3) difficulties in judging stairs, and (4) difficulties in grasping objects.

Results We found neuroanatomical correlates of the HH in all 21 participants, with the optic radiation being involved in almost all participants (20/21). Everyday problems possibly related to the HH were reported for all nine patients with postneonatally acquired complete hemianopias. In contrast, no such problems were reported for seven patients with incomplete HH (7/7) and for 3/5 patients with complete hemianopias due to pre-, peri- or neonatally acquired brain lesions.

Interpretation A dedicated radiologic analysis of the retrochiasmatic optic pathway should routinely be performed in children with brain lesions to identify children with HH. Early onset and incomplete HH are predictors for successful compensation.

Keywords

homonymous hemianopia - visual field defects - MRI study - neuroanatomical correlates - everyday problems
 

  • References

  • 1 Harbert MJ, Yeh-Nayre LA, O'Halloran HS, Levy ML, Crawford JR. Unrecognized visual field deficits in children with primary central nervous system brain tumors. J Neurooncol 2012; 107 (03) 545-549
    CrossrefPubMedGoogle Scholar
  • 2 Tinelli F, Guzzetta A, Bertini C. , et al. Greater sparing of visual search abilities in children after congenital rather than acquired focal brain damage. Neurorehabil Neural Repair 2011; 25 (08) 721-728
    CrossrefPubMedGoogle Scholar
  • 3 Jacobson L, Lennartsson F, Pansell T, Oqvist Seimyr G, Martin L. Mechanisms compensating for visual field restriction in adolescents with damage to the retro-geniculate visual system. Eye (Lond) 2012; 26 (11) 1437-1445
    CrossrefPubMedGoogle Scholar
  • 4 Trauzettel-Klosinski S. Rehabilitation for visual disorders. J Neuroophthalmol 2010; 30 (01) 73-84
    CrossrefPubMedGoogle Scholar
  • 5 Philip SS, Dutton GN. Identifying and characterising cerebral visual impairment in children: a review. Clin Exp Optom 2014; 97 (03) 196-208
    CrossrefPubMedGoogle Scholar
  • 6 Goodwin D. Homonymous hemianopia: challenges and solutions. Clin Ophthalmol 2014; 8: 1919-1927
    PubMedGoogle Scholar
  • 7 Kedar S, Zhang X, Lynn MJ, Newman NJ, Biousse V. Pediatric homonymous hemianopia. J AAPOS 2006; 10 (03) 249-252
    CrossrefPubMedGoogle Scholar
  • 8 Liu GT, Galetta SL. Homonymous hemifield loss in childhood. Neurology 1997; 49 (06) 1748-1749
    CrossrefPubMedGoogle Scholar
  • 9 Staudt M, Ivanov I, Küster S. , et al. Explorative saccade training in children with homonymous hemianopia. Neuropediatrics 2017; 48 (01) S1-S45
    PubMedGoogle Scholar
  • 10 Schiefer U, Schiller J, Hart W. Perimetry. In: Schiefer U, Wilhelm H, Hart W. , eds. Clinical Neuro-Ophthalmology: A Practical Guide. Berlin Heidelberg: Springer; 2007: 29-53
    Google Scholar
  • 11 Sloan LL. The Tubinger perimeter of Harms and Aulhorn. Recommended procedures and supplementary equipment. Arch Ophthalmol 1971; 86 (06) 612-622
    CrossrefPubMedGoogle Scholar
  • 12 Garber N. Tangent screen perimetry (continuing education credit). J Ophthalmic Nurs Technol 1994; 13 (02) 69-76 , quiz 84–85
    PubMedGoogle Scholar
  • 13 Zhang X, Kedar S, Lynn MJ, Newman NJ, Biousse V. Homonymous hemianopias: clinical-anatomic correlations in 904 cases. Neurology 2006; 66 (06) 906-910
    CrossrefPubMedGoogle Scholar
  • 14 Smith JL. Homonymous hemianopia. A review of one hundred cases. Am J Ophthalmol 1962; 54: 616-623
    CrossrefPubMedGoogle Scholar
  • 15 Trobe JD, Lorber ML, Schlezinger NS. Isolated homonymous hemianopia. A review of 104 cases. Arch Ophthalmol 1973; 89 (05) 377-381
    CrossrefPubMedGoogle Scholar
  • 16 Bajandas FJ, Mcbeath JB, Smith JL. Congenital homonymous hemianopia. Am J Ophthalmol 1976; 82 (03) 498-500
    CrossrefPubMedGoogle Scholar
  • 17 Dutton GN, Jacobson LK. Cerebral visual impairment in children. Semin Neonatol 2001; 6 (06) 477-485
    CrossrefPubMedGoogle Scholar
  • 18 Zhang Y, Wan SH, Wu GJ, Zhang XL. Magnetic resonance diffusion tensor imaging and diffusion tensor tractography of human visual pathway. Int J Ophthalmol 2012; 5 (04) 452-458
    PubMedGoogle Scholar
  • 19 Lilja Y, Nilsson DT. Strengths and limitations of tractography methods to identify the optic radiation for epilepsy surgery. Quant Imaging Med Surg 2015; 5 (02) 288-299
    PubMedGoogle Scholar