A 12-year-old Boy with Homonymous Hemianopia Caused by Neuromyelitis Optica Spectrum Disorder

Hara Yuji, Suzuki Tone, Machida Shigeki

doi:10.11476/shinkeiganka.36.54

<p>　We report the case of a 12-year-old boy with homonymous hemianopia caused by neuromyelitis optica spectrum disorder（NMOSD）. He was referred to our hospital due to decreased visual acuity. His corrected visual acuity was 1.2 in both eyes. His pupillary response was prompt without relative afferent pupillary defect. Bilateral optic discs appeared normal. Visual field examinations showed left homonymous hemianopia. Optical coherence tomography revealed thinning of the inner retinal layer of the macula that was consistent with homonymous hemianopia. Head fluid-attenuated inversion recovery magnetic resonance imaging（MRI）showed a hyperintense lesion continuous from the hypothalamus to the third ventricle. A blood test showed that he was positive for anti-aquaporin-4 antibody and negative for anti-myelin oligodendrocyte glycoprotein antibody and anti-N-methyl-D-aspartate receptor antibody. Consequently, he was diagnosed with NMOSD. Cerebrospinal fluid test results were normal. He was admitted to the pediatric ward and started on 1000 mg methylprednisolone per day for 3 days. This was repeated for another cycle. We have been gradually reducing the dose of methylprednisolone and he is currently taking 25 mg per day. MRI showed a decrease in the size of the lesion, and although he still has left homonymous hemianopia, it is improving.<br>　NMOSD commonly occurs in middle-aged woman. The present case occurred in a 12-year-old boy who presented with left homonymous hemianopia, probably caused by the right occipital lesion.</p>

A 12-year-old Boy with Homonymous Hemianopia Caused by Neuromyelitis Optica Spectrum Disorder

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